Date : 00.00.00
Name of the Patient : Abc Xyzmar Milmn / M / 38 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.
CLINICAL PROFILE :
C/O tingling in all 4 extremities and numbness in the right side of body since 15 days. Past H/O similar episodes.
M.R.I of the brain was performed using the following parameters :
5 mm thick T1 Weighted, proton and T2 Weighted axial images.
5 mm thick FLAIR coronal images.
There is evidence of a large area of hypointensity on the T1 Weighted images which turns hyperintense on the proton, T2 Weighted and FLAIR images within the white matter in the left fronto-temporal lobes. It is seen to extend into the posterior limb of the internal capsule, external capsule, lentiform nucleus and thalamus on the left side. This lesion is seen to abut and indent the atrium and posterior body of the left lateral ventricle (scans 103.9-14, 102.9-14, 105.5-13).
Another suspicious smaller lesion is located in the pons centrally (scans 103.4-5, 105.8, 102.4-5).
There is mild fullness of both the lateral ventricles. There is mild prominence of the cerebral cortical sulci bilaterally.
The third and the fourth ventricles are normal. The basal cisternal spaces are unremarkable. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.
The dorsal spine was screened with 4 mm thick T2 Weighted sagittal images and does not show any significant feature of note.
The MRI features are suggestive of an area of altered signal in the left fronto-temporal lobe and another suspicious area in the pons as described. These are not specific for a single etiology. The differential diagnosis would include :
1. Plaques of demyelination.
2. Evolving granulomas.
3. Neoplastic process - less likely.
A contrast enhanced scan may be worthwhile.