Date : 00.00.00
Name of the Patient : Abc Xylmn / M / 51 yrs.
Referred by : Dr. Abc Xyz Sane.
Examination : M.R.I. of the Brain.
CLINICAL PROFILE :
C/O headaches, gait imbalance, involuntary movements of the LLE and decreased sensation in the LUE and LLE since 2 months.
Known Hypertensive & Diabetic.
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.
There is an ill-defined, hypointense signal on the T1 Weighted images in the marrow of the clivus. This lesion appears hyperintense on the T2 Weighted images. Intermediate signal intensity soft tissue lesion on the T1 Weighted images is noted in the posterior nasopharyngeal wall. This lesion appears hyperintense on the T2 Weighted images. Resultant effacement of the torus tabarius is noted. Probable erosion of the floor of the sphenoid sinus is noted.
Mucosal thickening is noted in the sphenoid sinus with inflammatory changes in the mastoid air cells, bilaterally more marked on the right side.
There is no focal area of altered signal in the brain parenchyma per se.
There is mild dilatation of both the lateral ventricles. The third and the fourth ventricles are normal. There is prominence of the cerebral cortical sulci and cerebellar folia bilaterally. The basal cisternal spaces are unremarkable. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.
Altered signal in the marrow of the clivus with a soft tissue lesion in the posterior nasopharyngeal wall as described is not specific for a single etiology. A nasopharyngeal carcinoma/lymphoma or an infective lesion like tuberculosis should be considered as a differential diagnosis.