/59 Date : 00.00.00
Name of the Patient : Abc Xyza Nlmn / F / 22 yrs.
Referred by : Dr. Abc Xyzchale.
Examination : M.R.I. of the Brain.
CLINICAL PROFILE :
C/O altered sensorium since 4 days.
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.
After administration of contrast, the following parameters were used :
5 mm thick T1 Weighted axial images with magnetization transfer.
5 mm thick T1 Weighted coronal and sagittal images.
There is gyral thickening in both the cerebral hemispheres and they show a hyperintense signal on the proton, T2 Weighted and FLAIR images. Areas with similar signal characteristics are noted within the hippocampus and para-atrial white matter bilaterally and splenium of the corpus callosum.
After contrast administration, there is no focal area of abnormal enhancement within the brain parenchyma or along the meninges on the scan.
Both the 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.
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Note is made of inflammatory changes in the ethmoidal air cells and sphenoid sinus.
The cervical spine was screened with the help of 4 mm thick T2 Weighted sagittal images and does not reveal any diagnostic feature of note.
The MRI features are suggestive of altered signal involving the gyri in the cerebral hemispheres bilaterally and within the hippocampus and the para-atrial white matter bilaterally and splenium of the corpus callosum and this is not specific for a single diagnosis.
The differential diagnosis would include :
1. Hypoxic ischemic changes (? poisoning).
2. Viral encephalitis.
3. Post-epilepsy status.