Date : 00.00.00
Name of the Patient : Abc Xyzh Mhalmn / M / 25 yrs.
Referred by : Dr. Abc Xyzrges.
Examination : M.R.I. of the Brain.
CLINICAL PROFILE :
C/O fever, headaches with neck stiffness (since 10-15 days) and inability to swallow liquids and solid since 7-8 days.
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.
5 mm thick T1 Weighted sagittal images.
There is seen a fairly large approximately 3.5 x 3.5 x 3.0 cms sized, well-marginated hypointense lesion on the T1 Weighted images in the right cerebellar hemisphere with its broad base towards the petrous temporal bone. This lesion appears hyperintense on the proton, T2 Weighted and FLAIR images with a peripheral hypointense rim. There is perilesional edema with compression and displacement of the fourth ventricle to the left and effacement of the peripontine and right ambient cistern. There is herniation of the cerebellar tonsils through the foramen magnum.
There is moderate dilatation of both the lateral and the third ventricles with an ill-defined, hyperintense signal on the proton, T2 Weighted and FLAIR images in the periventricular white matter bilaterally suggesting a periventricular CSF ooze. Effacement of the cortical sulcal space is noted bilaterally.
No obvious vascular anomaly is identified on this study.
Inflammatory changes are noted in the ethmoidal air cells and right maxillary antrum.
An approximately 3.5 x 3.5 x 3.0 cms sized mass lesion in the right cerebellar hemisphere as described may represent a cerebellar abscess in the given clinical setting with surrounding mass effect. A cystic posterior fossa neoplasm however cannot be entirely excluded. There is resultant moderate obstructive hydrocephalus with periventricular CSF ooze.
A contrast enhanced scan may be worthwhile (patient refused contrast study).