Date : 00.00.00
Name of the Patient : Abc Xyzi Baswalmn / F / 65 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.
CLINICAL PROFILE :
C/O headaches and tremors of BUE with slight gait imbalance.
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.
Areas which are near isointense to CSF on all the pulse sequences are seen within the white matter in the right frontal lobe adjacent to the frontal horn of the right lateral ventricle. Areas of hyperintensity on the proton, T2 Weighted and FLAIR images are seen adjacent to these lesions and would represent gliotic changes. These lesions would represent lacunar infarcts. A speck of hypointensity on the Fast Scan (T2 *) images adjacent to one of these lesions would represent paramagnetic substances. There is slight ex-vacuo dilatation of the right frontal horn.
Areas of hyperintensity on the proton, T2 Weighted and FLAIR images are seen within the white matter in the fronto-parietal lobes and within the periatrial white matter bilaterally. These are iso to hypointense to white matter on the T1 Weighted images and are most likely ischemic in etiology. Prominent Virchow-Robin spaces are noted within both lentiform nuclei.
There is fullness of the third and both the lateral ventricles. Also seen is prominence of the cerebral cortical sulci and cerebellar folia bilaterally.
The fourth ventricle is normal. The basal cisternal spaces are prominent. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.
The MRI features are suggestive of :
1. Lacunar infarcts within the white matter in the right frontal lobe adjacent to the frontal horn of the right lateral ventricle.
2. Areas of altered signal within the white matter in the fronto-parietal lobes and within the periatrial white matter bilaterally are most likely ischemic in etiology.