Date : 00.00.00
Name of the Patient : Abc Xyztulla Shlmn / M / 14 yrs.
Referred by : Dr. Abc Xyzzzare.
Examination : M.R.I. of the Brain.
CLINICAL PROFILE :
Alleged H/O fall from a bicycle 5 months back with injury to head.
C/O progressive weakness of BLE and RUE 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.
5 mm thick FLAIR coronal images.
The cervical spine was screened with 4 mm thick T2 Weighted sagittal images.
There are ill-defined hypointense areas on the T1 Weighted images in the posterior parietal periventricular white matter bilaterally, bilateral centrum semiovale and in the posterior body and splenium of the corpus callosum. These lesions appear hyperintense on the proton, T2 Weighted and FLAIR images. Small areas are seen in the frontal periventricular white matter bilaterally.
There is mild fullness of the posterior body of the lateral ventricles bilaterally.
The third and the fourth ventricles are normal. The basal cisternal spaces are unremarkable. There is slight prominence of the cerebral cortical sulci bilaterally. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.
The T2 Weighted sagittal images of the cervical spine do not reveal any significant feature of note.
Altered signal in the posterior parietal and frontal periventricular white matter bilaterally, bilateral centrum semiovale and in the posterior body and splenium of the corpus callosum is not specific for a single etiology. These changes most likely represent demyelinating lesions (?dysmyelination eg. adrenoleukodystrophy and adrenomyeloneuropathy). Multiple sclerosis/progressive multifocal leukoencephalopathy should be ruled out.