Date : 00.00.00
Name of the Patient : Abc Xyzsh Ylmn / M / 5 yrs.
Referred by : Dr. Abc Xyztel.
Examination : M.R.I. of the Brain.
CLINICAL PROFILE :
H/O fever 1 year back with progressive gait ataxia and altered behaviour (smiling/laughing/crying).
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.
MR cisternogram was obtained in the sagittal plane.
There is seen a fairly large, expansile mass lesion in the brainstem extending from the lower midbrain upto the proximal medulla. This lesion is hypointense on the T1 Weighted images and turns hyperintense on the proton and T2 Weighted images. There is resultant effacement of the peripontine, paramedullary and the quadrigeminal plate cisterns and compression of the fourth ventricles. Cerebellar tonsillar herniation through the foramen magnum is noted. A probable syrinx is noted in the upper cervical spinal cord.
There is mild dilatation of both the lateral and third ventricles. Periventricular white matter hyperintense signal on the T2 Weighted images may represent periventricular CSF ooze.
There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.
A fairly large, expansile mass lesion in the brainstem as described, most likely represents a glial cell neoplasm of the brainstem. There is resultant mild obstructive hydrocephalus with periventricular white matter hyperintense signal suggesting periventricular CSF ooze.
A contrast enhanced scan would be worthwhile.