Date : 00.00.00
Name of the Patient : Abc XyzHlmn / F / 25 yrs.
Referred by : Dr. Abc Xyzbar.
Examination : Intracranial MR Venogram.
CLINICAL PROFILE :
H/O abortion at 5 months, 15 days back with convulsions 12 days back.
Loss of consciousness since then.
The brain was screened with the help of 5 mm thick T1 Weighted and T2 Weighted axial images and 5 mm thick T1 Weighted sagittal images.
MRV was performed using a 2D TOF technique.
There is evidence of a diffuse area of hypointensity on the T1 Weighted images which turns hyperintense on the T2 Weighted images involving the white matter and the cortical gray matter in the left temporo-fronto-parietal lobes with effacement of the adjacent cerebral cortical sulci. Areas of hyperintensity on the T1 Weighted images within this lesion would most likely represent subacute blood.
A small hyperintense area is noted on the T2 Weighted images in the pons on the left side and is hypointense on the T1 Weighted images. This is probably ischemic in etiology.
There is compression upon the left lateral ventricle, aqueduct and the third ventricle and left cerebral peduncle with a shift of the midline to the right. Also seen is left uncal herniation and effacement of the left perimesencephalic cistern.
There is mild dilatation of the right lateral ventricle.
Inflammatory changes are seen within the mastoid air cells bilaterally.
INTRACRANIAL MRV :
On the MRV a streak of flow is seen within the left transverse and sigmoid sinuses (? hypoplastic ? recanalized thrombus).
The rest of the visualized dural and deep venous sinuses show normal flow characteristics.
The MRV features are suggestive of :
1. An area of altered signal within the left temporo-fronto-parietal lobes which most likey represents a haemorrhagic infarct (probably venous).
2. Ischemic focus in the pons on the left side.
3. Inflammatory changes within the mastoid air cells bilaterally.
4. A streak of flow within the left transverse and sigmoid sinuses (? hypoplastic ? recanalized thrombus).