Date : 00.00.00
Name of the Patient : Abc Xyza Anlmn / F / 6 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.
CLINICAL PROFILE :
H/O fall from a bed 8-9 months back with weakness of BUE and BLE and speech impairment 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.
4 mm thick FLAIR and Fast Scan (T2 *) coronal images.
5 mm thick T1 Weighted sagittal images.
There are hypointense areas on the T1 Weighted images within the head of the caudate nucleus and the putamen bilaterally. These are seen to turn hyperintense on the proton, T2 Weighted, FLAIR and Fast Scan (T2 *) images. There is indentation on the frontal horns of the lateral ventricles.
Hyperintense areas are seen on the proton, T2 Weighted and FLAIR images in the left temporo-parietal and right parietal white matter. These are iso to hypointense on the T1 Weighted images.
The 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.
The MRI features are suggestive of altered signal intensity in the head of the caudate nucleus and putamen bilaterally, left temporo-parietal and right parietal deep white matter and is not specific for a single etiology. Metabolic brain disorders like mitochondrial encephalopathies and Wilsons disease should be ruled out.
Hypoxic-ischemic insult should also be considered as a differential diagnosis, though less likely (in view of the long standing history)