Date : 00.00.00
Name of the Patient : Abc Xyz Ralmn / M / 56 yrs.
Referred by : Dr. Abc Xyzmat.
Examination : M.R.I. of the Brain.
CLINICAL PROFILE :
Alleged H/O vehicular accident on 00.00.00 with weakness of the LUE and LLE with slurred speech since then.
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 and Fast Scan (T2 *) coronal images.
5 mm thick T1 Weighted sagittal images.
After administration of contrast, the following parameters were used :
5 mm thick T1 Weighted axial, sagittal and coronal images.
FEW OF THE IMAGES SHOW PATIENT MOTION.
There is a large, ill-defined hypointense area having its epicentre in the right lentiform nucleus on the T1 Weighted images. This is seen to involve the gyri of the insular cortex. Anteriorly the gyri along the parafalcine frontal region bilaterally are also involved. Medially the head of the caudtae nucleus is involved. There is inferior extension into the medial aspect of both the temporal lobes with uncal herniation on the right side and indentation upon the right cerebral peduncle. Hypointense areas are also noted on the T1 Weighted images within
the thalami bilaterally and the right subthalamus. There is mass effect with effacement of the adjacent sulci, right Sylvian fissure and the quadrigeminal cistern on the right side. There is compression upon the body of the right lateral and the third ventricles with shift of the midline structures to the left. Also seen is involvement of the left temporal lobe. Few areas which are hypointense on the T1 Weighted and STIR images are seen within this lesion on the right side and these may represent cystic/necrotic changes.
After administration of contrast, there is slight enhancement of this lesion in the region of the right uncus.
The fourth ventricle is normal.
The MRI features are suggestive of a lesion involving both cerebral hemispheres as described and most likely represents a neoplastic process like a glial cell tumor ? gliomatosis cerebri
or lymphoma (?? encephalitis).