Date : 00.00.00
Name of the Patient : Abc Xyzl Palmn / M / 55 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.
CLINICAL PROFILE :
C/O right hemiparesis with slurred speech since 15 days with decreased hearing since 6 years.
Known hypertensive. On Rx.
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.
There is evidence of a well-defined wedge shaped area which is isointense to CSF on all the pulse sequences within the left temporal lobe. This is surrounded by hypointense areas on the T1 Weighted images which turn hyperintense on the proton, T2 Weighted and FLAIR images and would represent gliotic changes. This lesion in toto would represent an area of cystic encephalomalacia.
Multiple areas which are iso to hyperintense to CSF on all the pulse sequences are noted within the right periatrial white matter, left corona radiata, head of the caudate nuclei, pons and the lentiform nuclei. These would represent lacunar infarcts. A few of these are surrounded by hyperintense areas on the proton, T2 Weighted and FLAIR images which would represent gliotic changes.
Areas of hyperintensity on the proton, T2 Weighted and FLAIR images are seen within the periventricular white matter and the white matter in the fronto-parietal lobes bilaterally. These are iso to hypointense to normal white matter on the T1 Weighted images and are most likely ischemic in etiology.
There is mild fullness of the third and both the lateral ventricles. Also seen is mild prominence of the cerebral cortical sulci bilaterally.
The fourth ventricle is 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 MRI features are suggestive of :
1. An area of cystic encephalomalacia within the left temporal lobe.
2. Lacunar infarcts within the right periatrial white matter, left corona radiata, head of the caudate nuclei, pons and the lentiform nuclei.
3. Altered signal within the periventricular white matter and the white matter in the fronto-parietal lobes bilaterally are most likely ischemic in etiology.