Date : 00.00.00
Name of the Patient : Abc Xyzhatarlmn / M / 50 yrs.
Referred by : Dr. Abc Xyztel.
Examination : M.R.I. of the Brain.
CLINICAL PROFILE :
C/O sudden onset of right sided weakness with blurred vision of left eye since 3-4 days with drowsiness and irrelevant talk since 1-2 days.
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 and Fast Scan (T2 *) coronal images.
There is a large ill-defined, hypointense lesion on the T1 Weighted images in the left cerebral peduncle extending into the left thalamus and inferiorly into the left side of the pons and left middle cerebellar peduncle. This lesion is seen to turn hyperintense on the proton, T2 Weighted and FLAIR images. There is surrounding edema with mass effect and mild indentation upon the superior portion of the fourth ventricle, aqueduct and the third ventricle with mild shift of the midline structures to the right side. Minimal edema is also noted in the right cerebral peduncle and the left lentiform nucleus. This lesion does not bloom on the Fast Scan (T2 *) images.
There is mild fullness of both the lateral ventricles with slight prominence of the cerebral cortical sulci.
No obvious vascular anomaly is identified on this study.
Incidental note is made of inflammatory changes in the
ethmoidal and mastoid air cells on the right side.
The MRI features are suggestive of a mass lesion in the left cerebral peduncle with extensions as described. The possibilities to be considered are,
2. Demyelinating lesion.
3. Neoplastic lesion (less likely).
A contrast enhanced scan would be worthwhile.