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ke/sb/rg.
Date : 00.00.00

Name of the Patient : Abc Xyza Shlmn / F / 28 yrs.
Referred by : Dr. Abc Xyzgaonkar.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O headaches and diplopia since 2-3 months with vomiting since 1 year.

EXAMINATION :

M.R.I of the brain was performed using the following parameters :

5 mm thick T1 Weighted, proton and T2 Weighted axial images.
4 mm thick FLAIR coronal images.
MR Cisternogram was obtained in the coronal plane.
5 mm thick T1 Weighted sagittal images.

After administration of contrast the following parameters were used :

3 mm thick T1 Weighted coronal images.
5 mm thick T1 Weighted axial and sagittal images with magnetization transfer.

OBSERVATION :

There is a large lesion in the left deep posterior temporo-parietal region which measures approximately 2.3 x 2.7 x 2.2 cms. and probably arises from the atrium of the left lateral ventricle. This lesion is of mixed signal characteristics and is predominantly hyperintense at the periphery and hypointense in the centre on the T1 Weighted images. The periphery is seen to turn hypointense on the proton and T2 Weighted images with the centre turning hyperintense. Few punctate hypointense lesions are seen at the periphery of this lesion on all the pulse sequences and may represent vessels. There is gross surrounding white matter edema in the left temporo-occipito-parietal region with effacement of the adjacent sulci and the left Sylvian fissure. The edema is also seen to encroach into the posterior limb of the left internal capsule. There is mass effect with compression
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of the body of the left lateral ventricle and the third ventricle with shift of the midline structures to the right. The temporal horn and the occipital horn as well as the frontal horn of the left lateral ventricle are compressed. The midbrain is also deformed with effacement of the perimesencephalic cistern.

There is homogeneous enhancement of this lesion on administration of contrast. There is no other area of abnormal enhancement in the brain parenchyma or along the meninges.

There is dilatation of the right lateral ventricle with periatrial CSF ooze.

The fourth ventricle is normal. No obvious vascular anomaly is identified on this study.

IMPRESSION :

The MRI features are suggestive of a mass lesion in the left deep posterior temporo-parietal region measuring approximately 2.3 x 2.7 x 2.2 cms. with extensions as described. This lesion most likely arises in the atrium of the left lateral ventricle and represents an intraventricular meningioma. The possibility of a granuloma seems less likely.

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