Date : 00.00.00
Name of the Patient : Abc Xyzen Chlmn / F / 38 yrs.
Referred by : Dr. Abc Xyzchale.
Examination : M.R.I. of the Brain.
CLINICAL PROFILE :
H/O giddiness with fall 8 days back.
C/O gait ataxia and drooping of the left eyelid 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.
3 mm thick Fast Scan (T2 *) coronal images.
5 mm thick T1 Weighted sagittal images.
There is a popcorn shaped lesion within the midbrain on the left side which measures approximately 1.5 x 2.2 x 2.3 cms. This lesion is seen to extend inferiorly into the pons. There is slight mass effect with mild indentation upon the aqueduct and effacement of the interpeduncular cistern. This lesion shows a isointense centre on the T1 Weighted images which is seen to turn hyperintense on the T2 Weighted images. A hyperintense signal is seen at the periphery of this lesion on the T1 Weighted images which turns hypointense on the proton, T2 Weighted and FLAIR images. There is blooming of the periphery on the Fast Scan (T2 *) images and the lesion in toto would represent altered blood. There is minimal surrounding edema.
Similar but smaller lesions are seen in the left posterior parietal region (se/im 102.11, 103.11, 102.15, 106.2) and adjacent to the left Sylvian fissure (se/im 106.13, 103.11, 102.11, 105.13) with no surrounding edema and no mass effect.
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.
The MRI features are suggestive of a cavernous angioma in the midbrain on the left side (which has bled recently) and two other similar lesions in the left posterior parietal region and left Sylvian fissue.