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sb/hs/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzati lmn / F / 80 yrs.
Referred by : Dr. Abc Xyzsai.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O altered sensorium since 4 days with ? episode of hypotension.
Past H/O stroke 2 1/2 years back.

EXAMINATION :

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 and Fast Scan (T2 *) coronal images.

OBSERVATION :

The gyri in the left cerebral hemisphere appear swollen and appear hypointense on the T1 Weighted images and hyperintense on the proton, T2 Weighted and FLAIR images. Similar signal changes are noted in the head of the left caudate nucleus and left lentiform nucleus. Resultant effacement of the sulcal spaces in the left cerebral hemisphere is noted with indentation on the left lateral ventricle and minimal bulge of the midline structures to the right. Indentation on the left cerebral peduncle by the left medial temporal lobe is also noted.

There is a CSF signal intensity lesion on all the pulse sequences in the left occipital lobe. This represents an area of cystic encephalomalacia, most likely the sequelae of previous vascular insult.

Ill-defined hyperintense signal on the proton, T2 Weighted and FLAIR images is noted in the right high fronto-parietal cortex which also most likely represents a recent ischemic lesion.





Hyperintense signal on the proton, T2 Weighted and FLAIR images in the pons on the right, right posterior parietal periventricular white matter and in the right basal ganglionic region represents ischemic lesions.

There is mild dilatation of the right lateral ventricle. The fourth ventricle is normal. There is prominence of the cerebral cortical sulci in the right cerebral hemisphere, the cerebellar folia and the basal cisternal spaces bilaterally. No obvious vascular anomaly is identified on this study.

Inflammatory changes are noted in the mastoid air cells bilaterally and in the right maxillary antrum.

There is no obvious evidence of hemorrhage on this study.

Incidentally noted is an empty sella.

IMPRESSION :

1. Altered signal along the gyri in the left cerebral hemisphere, in the head of the left caudate nucleus and left lentiform nucleus represents a recent ischemic lesion.

2. An area of cystic encephalomalacia, (most likely the sequelae of a previous vascular insult) in the left occipital lobe.

3. Altered signal in the right high fronto-parietal cortex also most likely represents a recent ischemic lesion.

4. Altered signal in the pons on the right, right posterior parietal periventricular white matter and in the right basal ganglionic region represent ischemic lesions.




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