Date : 00.00.00
Name of the Patient : Abc Xyzar Almn / M / 55 yrs.
Referred by : Dr. Abc Xyzrnad.
Examination : M.R.I. of the Brain.
CLINICAL PROFILE :
C/O generalized weakness since 2 months.
H/O hoarseness of voice 1 week back.
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.
3 mm thick T1 Weighted sagittal images and 3 mm thick T2 Weighted coronal images through the sella and perisellar region.
There is volume loss in the right parieto-occipital region, right frontal region and in the right anterior temporal region. There is a CSF signal intensity lesion on all the pulse sequences in these regions, which represents areas of cystic encephalomalacia, most likely the sequelae of previous vascular insult. Perilesional hyperintense signal on the T2 Weighted and FLAIR images represents gliotic changes. Mild focal dilatation of the atrium and posterior body of the right lateral ventricle is noted.
Small bright foci on the T2 Weighted and FLAIR images in the right centrum semiovale (in the watershed zone of the ACA and MCA) also represent ischemic changes. The petrous and cavernous segments of the right internal carotid artery show evidence of an intraluminal signal in place of the normal flow void signal suggesting a thrombus/slow flow.
There is mild dilatation of both the lateral and third ventricles. The fourth ventricle is normal. There is slight prominence of the cerebral cortical sulci and basal cisternal spaces bilaterally. There is no shift of the midline structures.
The pituitary gland appears normal in height without focal mass lesion. The pituitary stalk is in the midline. Perisellar region is unremarkable.
Inflammatory changes are noted in the ethmoidal air cells bilaterally.
1. Areas of cystic encephalomalacia in the right parieto-occipital region, right frontal region and in the right anterior temporal region most likely the sequelae of previous vascular insult.
2. Slow flow/thrombus in the petrous and cavernous segments of the right internal carotid artery.
3. Ischemic changes in the right centrum semiovale (in the watershed areas of the ACA and MCA).
An MRA would be worthwhile.