Date : 00.00.00
Name of the Patient : Abc XyzPoonalmn / M / 56 yrs.
Referred by : Dr. Abc Xyzrawala.
Examination : M.R.I. of the Brain.
CLINICAL PROFILE :
C/O giddiness since 1 day.
H/O left sided hemiplegia 2 years ago from which patient has recovered.
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 coronal images.
5 mm thick T1 Weighted sagittal images.
There is an ill-defined, hypointense area on the T1 Weighted images in the right temporo-fronto-parieto-occipital lobes and which is seen to follow CSF signal intensity characterisitcs on all the pulse sequences. Hyperintense areas are noted on the proton, T2 Weighted and Flair images at the periphery of this lesion. These are hypointense to normal white matter and would represent areas of gliosis. Resultant ex-vacuo dilatation of the body, temporal horn and occipital horn of the right lateral ventricle is seen. This lesion would represent an area of cystic encephalomalacia.
Hyperintense areas are seen on the proton, T2 Weighted and Flair images within the pons. These are iso to hypointense to white matter on the T1 Weighted images and these would represent ischemic areas. Similar small bright foci are seen in the fronto-parietal deep white matter bilaterally.
An intermediate signal intensity area is seen within the cavernous portion of the right internal carotid artery on the T1 Weighted images and which is heterogeneously hyperintense on the proton and T2 Weighted images and would represent slow flow. The internal carotid artery in this region appears smaller in calibre.
There is slight fullness of the left lateral and third ventricles. The fourth ventricle is normal. The basal cisternal spaces are unremarkable. There is no shift of the midline structures.
Incidental note is made of inflammatory changes in the right maxillary sinus and right mastoid air cells.
1. An area of cystic encephalomalacia in the right temporo-fronto-parieto-occipital lobes.
2. Areas of altered signal within the pons and in the fronto-parietal deep white matter bilaterally would represent ischemic changes.
3. Smaller calibre of the right internal carotid artery as compared to the opposite side.