Date : 00.00.00
Name of the Patient : Abc Xyzdra Klmn / M / 45 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.
CLINICAL PROFILE :
C/O seizures since 2 years.
Also C/O gait imbalance and vomiting.
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 T2 Weighted coronal images.
After administration of contrast the following parameters were used :
5 mm thick T1 Weighted axial and coronal images with magnetization transfer.
5 mm thick T1 Weighted sagittal images.
There are irregularly defined areas of hypointensity on the T1 Weighted images which turn hyperintense on the proton, T2 Weighted and FLAIR images within the left periatrial white matter and right frontal white matter. These most likely represent gliotic/encephalomalacic changes. A focal area with similar signal characteristics is seen within the right paraatrial white matter.
The left hippocampus appears smaller as compared to the right side and shows a hyperintense signal on the T2 Weighted images.
There is prominence of the cerebellar folia bilaterally with fullness of the fourth ventricle. Also seen is mild prominence of the cerebral cortical sulci bilaterally.
Both the lateral and the third 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.
A focal lesion which is hypointense on all the pulse sequences is seen in the region of the right eyelid laterally and is not specific for a single etiology (? fibroma).
After administration of contrast, there is no area of abnormal enhancement within the brain parenchyma or along the meninges.
The MRI features are suggestive of :
1. Areas of altered signal within the left periatrial white matter, right frontal white matter and in the right paraatrial white matter and these most likely represent gliotic/encephalomalacic changes.
2. Left hippocampal sclerosis.
3. Mild cerebellar atrophy.