Date : 00.00.00
Name of the Patient : Abc Xyz Mlmn / F / 24 yrs.
Referred by : Dr. Abc Xyzajan.
Examination : M.R.I. of the Brain.
CLINICAL PROFILE :
C/O intracranial tuberculoma detected in March 0000.
On AKT since then.
For follow up.
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.
After administration of contrast, the following parameters were used :5 mm thick T1 Weighted axial and coronal images with magnetization transfer.5 mm thick T1 Weighted sagittal images.OBSERVATION :
There are multiple, small focal, hypointense lesions on the proton and T2 Weighted images scattered in the brain parenchyma, in the right temporo-parietal region, right posterior parietal region and in the left cerebellar hemisphere, near the midline. These lesions appear iso to hypointense to normal white matter on the T1 Weighted images. There is perilesional edema around these lesions. Effacement of the sulcal spaces in the right posterior parietal region is noted with minimal indentation upon the occipital horn of the right lateral ventricle.
On administration of contrast, there is a large conglomeration of ring enhancing lesions in the right temporo-parietal region which measures approximately 2.1 x 3.4 x 1.6 cms. Some enhancement of the dura adjacent to this lesion is noted. Smaller, disc and ring enhancing lesions are noted in the left cerebellar hemisphere near the midline and right posterior parietal region. There are few hypointense areas on the proton and T2 Weighted images which probably represent calcification.
The left 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.
Inflammatory changes are noted in the ethmoidal air cells bilaterally.
IMPRESSION :Multiple, ring and disc enhancing lesions scattered in the brain parenchyma with signal characteristics as described, most likely represent tuberculous granulomas.
No previous investigations/scans were available for comparison.