Date : 00.00.00
Name of the Patient : Abc Xyz Parlmn / M / 32 yrs.
Referred by : Dr. Abc Xyzdar.
Examination : M.R.I. of the Brain.
CLINICAL PROFILE :
C/O fever since 25 days with single episode of seizures on 00.00.00.
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 T1 Weighted coronal images.
5 mm thick FLAIR coronal images.
After administration of contrast the following parameters were used :
5 mm thick T1 Weighted axial and coronal images with magnetization transfer.
5 mm thick T1 Weighted sagittal images.
There are ill-defined, hyperintense areas on the proton, T2 Weighted and FLAIR images in the subcortical white matter in the left cerebellar hemisphere, right anterior temporal region, right frontal region and in the left high parietal parafalcine region. These lesions appear hypointense to normal white matter on the T1 Weighted images. These lesions most likely represent perilesional edema. It is difficult to identify a focal lesion within the areas of perilesional edema.
There is a very small, hypointense lesion on the T1 Weighted images in the right cerebral hemisphere, inferiorly (scan 102.3). This lesion appears iso to hypointense on the T1 Weighted images.
After administration of contrast, there are multiple rim and disc enhancing lesions in the right cerebellar hemispheres, inferiorly, left cerebellar hemisphere, right medial temporal pole, right frontal region, right posterior parietal region and in the left posterior parietal parafalcine region.
Both the lateral, third and the fourth ventricles are normal. The basal cisternal spaces are unremarkable. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.
No obvious abnormal meningeal enhancement is noted on this study.
Multiple, very small, disc and rim enhancing lesions in the cerebral and cerebellar hemispheres bilaterally as described are not specific for a single etiology. These most likely represent multiple granulomas. The lesion in the right cerebellar hemisphere, inferiorly follows the signal characteristics of tuberculoma (scan 102.3).