Date : 00.00.00
Name of the Patient : Abc XyzDlmn / M / 43 yrs.
Referred by : Dr. Abc Xyzagwati.
Examination : M.R.I. of the Brain.
CLINICAL PROFILE :
Alleged H/O RTA 2 years ago with surgery for extracerebral hematoma with placement of a VP shunt.
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.
FEW IMAGES SHOW PATIENT MOTION.
Susceptibility artifacts are seen in both frontal regions and are most likely the result of surgical intervention.
Multiple areas which are isointense to CSF are seen in the frontal lobes bilaterally, left parietal lobe and both temporal lobes. Adjacent to these are areas which are hypointense on the T1 Weighted images and turn hyperintense on the proton, T2 Weighted and Flair images and would represent gliotic changes. These lesions in toto would represent areas of cystic encephalomalacia (? the result of previous contusions). There is ex-vacuo dilatation of the left lateral ventricle and the frontal and temporal horns of the right lateral ventricle.
Also seen is mild dilatation of the rest of the right lateral ventricle and the third ventricle. There is fullness of the aqueduct and the fourth ventricle. Turbulent flow is evident within the aqueduct and the third and fourth ventricles.
Areas of hypointensity on the T1 Weighted images which turn hyperintense on the proton, T2 Weighted and Flair images are noted within the cerebral peduncles bilaterally, left thalamus and pons (? ischemic in etiology, ?? gliosis).
The tip of the shunt tube appears to be penetrating the wall of the frontal horn of the left lateral ventricle.
There is prominence of the cerebral cortical sulci, cerebellar folia and basal cisternal spaces.
The vertebro-basilar system is ectatic.
There is no shift of the midline structures.
In a known C/O trauma the MRI features are suggestive of :
1. Post-operative status. The tip of the shunt tube appears to be lying outside the frontal horn of the left lateral ventricle.
2. Areas of cystic encephalomalacia the result of previous contusions within the frontal lobes bilaterally, left parietal lobe and both temporal lobes.
3. Mild dilatation of the ventricular system which needs to be compared with the previous scans.
Previous scans were not available for comparison.