Date : 00.00.00
Name of the Patient : Abc Xyz Nlmn / F / 46 yrs.
Referred by : Dr. Abc Xyzisheri.
Examination : M.R.I. of the Brain.
CLINICAL PROFILE :
C/O right hemiparesis with altered sensorium and fever since 4 days.
M.R.I of the brain was performed using the following parameters :
5 mm thick T1 Weighted and T2 Weighted axial images.
5 mm thick FLAIR coronal images.
5 mm thick T1 Weighted sagittal images.
Limited MR Venogram sequence was obtained in the coronal plane.
SOME SCANS SHOW PATIENT MOTION.
There are ill-defined, hyperintense areas on the T2 Weighted and FLAIR images in the frontal regions bilaterally, left posterior parietal region and to a much lesser extent in the right posterior parietal region. These lesions appear predominantly hypointense on the T1 Weighted images and are seen to involve the cortex and subcortical white matter. There is a hyperintense focus on all the pulse sequences within the left frontal region which represents subacute haemorrhage. There is resultant effacement of the sulcal spaces with mild indentation and inferior displacement of the left lateral ventricle by the lesion in the left posterior parietal region.
Both the lateral, third and the fourth ventricles are otherwise unremarkable. The basal cisternal spaces are unremarkable. There is no shift of the midline structures.
The superior sagittal sinus and partly the left transverse sinus do not show the normal flow void signal. In place, there is a hyperintense signal on all the pulse sequences within the above mentioned dural venous sinuses which represent a thrombus.
Limited MR Venogram reveals absence of normal flow signal in the superior sagittal sinus and a thin streak in the left transverse sinus. The left sigmoid sinus is well-visualized. The right transverse and sigmoid sinuses are not well-visualized (? hypoplasia). The internal cerebral veins, vein of Galen and straight sinus are unremarkable.
The MRI features described above suggest superior sagittal and left transverse sinus thrombosis with altered signal in the frontal regions and posterior parietal regions bilaterally, which most likely represent venous infarcts. The left frontal lesion shows evidence of haemorrhage.