Date : 00.00.00
Name of the Patient : Abc Xyza Jalmn / F / 23 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Cervical Spine.
CLINICAL PROFILE :
H/O high grade fever for 2-3 days with weakness of BLE 3 months back. Weakness still persists.
M.R.I of the cervical spine was performed using the following parameters :
4 mm thick T1 Weighted and T2 Weighted sagittal images.
5 mm thick T1 Weighted and Fast Scan (T2 *) axial images.
There are ill-defined hyperintense areas on the T2 Weighted and Fast Scan (T2 *) images within the cervical spinal cord involving the anterior and lateral columns, bilaterally. These are iso to hypointense to normal cord on the T1 Weighted images. Similar areas are also seen to involve the cervico-medullary junction.
A small posterior disc bulge is noted at the C4-C5 level with mild anterior indentation of the thecal sac. The cervical intervertebral discs show loss of water content.
The cervical vertebral bodies show normal signal intensity. The joints of Luschka and the visualized pre and paravertebral soft tissues are unremarkable.
The atlanto-axial region is unremarkable.
The dorsal spine was screened with 4 mm thick T2 Weighted sagittal images and shows altered signal in the lower dorsal spinal cord and conus medullaris.
The brain was screened with 5 mm thick T2 Weighted axial images and 3 mm thick STIR coronal images. Hyperintense areas are noted on the T2 Weighted images within the medulla and pons and left cerebral peduncle. The optic nerves show a subtle hyperintense signal on the STIR images.
Altered signal within the cervical spinal cord, cervico-medullary junction, medulla, pons and the left cerebral peduncle and the lower dorsal cord most likely represents demyelinating lesions. The optic nerves also show subtle altered signal.
The possibility of these lesions being due to ischemia/infarction seems less likely.