Date : 00.00.00
Name of the Patient : Abc Xyznt lmn / M / 15 yrs.
Referred by : Dr. Abc Xyzchale.
Examination : M.R.I. of the Brain.
CLINICAL PROFILE :
H/O fever with chills 12 days back with bladder involvement since 4 days with weakness in BUE and BLE and altered sensorium since 1 day.
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.
5 mm thick T1 Weighted sagittal images.
There is a subtle hyperintense signal on the proton and T2 Weighted images in the lower medulla and the cervico-medullary junction. This is isointense to normal white matter on the T1 Weighted images.
Both the lateral, 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 cervical and dorsal spines were screened with 4 mm thick T2 Weighted sagittal images, which show hyperintense signal within the centre of the spinal cord over the cervico-medullary junction upto the conus.
The MRI features are suggestive of altered signal in the lower medulla and the cervico-medullary junction upto the conus medullaris. In the given clinical setting of fever this most likely represents myelitis.
The other possibilities to be considered are demyelination or ischemia/infarction.