Date : 00.00.00
Name of the Patient : Abc Xyzmesh J. lmn / M / 7 mnths.
Referred by : Dr. Abc Xyzgarwal.
Examination : M.R.I. of the Brain.
CLINICAL PROFILE :
C/O seizures since 1 month.
H/O Ceasarian delivery.
M.R.I of the brain was performed using the following parameters :
5 mm thick T1 Weighted, proton and T2 Weighted axial images.
4 mm thick T2 Weighted coronal images.
4 mm thick T1 Weighted sagittal images.
Patients parents refused contrast administration.
There are few areas of hyperintensity on the T1 Weighted images located in both frontal and parietal lobes and right occipital lobe. (scans 108.14, 15, 12). These are seen to turn hypointense on the T2 Weighted images. There is surrounding hyperintensity on the proton and T2 Weighted images.
Both the lateral and third ventricles show fullness. The fourth ventricle is 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 myelination pattern appears normal for the patients age.
Areas of altered signal in both the frontal and parietal lobes and in the right occipital lobe are not specific for a single etiology. Also seen is fullness of both the lateral and third ventricles.
The differential diagnosis may include :
1. Granulomas like tuberculomas.
2. Tuberous sclerosis (cortical tubers).
3. ? Congenital infection e.g. Cytomegalovirus or Toxoplasmosis.
Is the patient immunocompromised ?.
A contrast enhanced scan would be worthwhile.