ke/sb/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzrilmn / F / 5 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

H/O birth asphyxia with delayed mental and motor milestones and inability to speak.
C/O seizures. On anti-epileptics.

EXAMINATION :

M.R.I of the brain was performed using the following parameters :

5 mm thick T1 Weighted, proton and T2 Weighted axial images.

3 mm thick T2 Weighted coronal images.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There are ill-defined hypointense lesions on the T1 Weighted images in the right occipital cortex and in the temporal regions bilaterally. These lesions appear hyperintense on the proton, T2 Weighted and FLAIR images and most likely represent old ischemic lesions.

There is seen a fairly large, approximately 4.1 x 4.0 x 5.1 cms sized well-defined, CSF intensity lesion on all the pulse sequences in the suprasellar cistern, compressing the floor of the third ventricle. Extension of this lesion into the interpeduncular cistern and prepontine cistern is noted with resultant splaying of the cerebral peduncles and posterior displacement of the midbrain and pons. The pituitary gland is seen along the floor of the sella. The pituitary stalk is displaced anteriorly. The optic chiasma and the optic tracts are elevated superiorly and the third ventricle is displaced posteriorly.


There is resultant moderate dilatation of both the lateral ventricles and effacement of the cerebral cortical sulcal spaces and the Sylvian cisterns.

The fourth ventricle is normal. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.

IMPRESSION :

1. Altered signal in the right occipital cortex and in the temporal regions bilaterally most likely represent old ischemic changes.

2. A fairly large, approximately 4.1 x 4.0 x 5.1 cms sized, CSF intensity mass lesion in the suprasellar cistern with extension as described most likely represents an arachnoid cyst. Resultant moderate dilatation of both the lateral ventricles is noted with sulcal space effacement.

As compared to the previous MRI (study no:00003) dated 00.00.00, there is no significant change noted.