Date : 00.00.00
Name of the Patient : Abc Xyza Tlmn / F / 34 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.
CLINICAL PROFILE :
C/O giddiness since 3 months with gait ataxia and mild headaches.
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 and coronal images with magnetization transfer.
5 mm thick T1 Weighted sagittal images.
There are ill-defined, hyperintense areas on the proton, T2 Weighted and FLAIR images in the cerebellar vermis in the right occipital pole, left frontal deep white matter extending into the left centrum semiovale, right frontal periventricular white matter and in the right frontal parafalcine region. These lesions appear iso to hypointense to normal white matter on the T1 Weighted images. After administration of contrast, there is nodular enhancement within the above described lesions. The enhancing lesions vary in size from about 6.0 mms to 1.1 cms in diameter. Minimal indentation on the frontal horn of the right lateral ventricle is noted by the lesion in the right frontal periventricular white matter.
Both the lateral, third and the fourth ventricles are otherwise unremarkable. The basal cisternal spaces are unremarkable. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.
There is no abnormal meningeal enhancement identified on this study.
Multiple, enhancing, nodular lesions in the cerebellar vermis and cerebral hemispheres bilaterally, with perilesional edema, as described, are not specific for a single etiology. These lesions may represent multiple granulomas (? tuberculomas, ?? toxoplasmosis). It is difficult to characterize the lesions on the basis of the signal intensity. Multiple metastases should also be ruled out.