ke/bv/nl/rg.
Date : 00.00.00
Name of the Patient : Abc Xyz Walmn / F / 39 yrs.
Referred by : Dr. Abc XyzM. Damania.
Examination : M.R.I. of the Brain.
CLINICAL PROFILE :
H/O Right sided mastectomy in November 0000. HP s/o infiltrating duct carcinoma Grade III. Received 9 cycles of chemotherapy.
C/O progressive weakness of right half of body with diminished vision since 3-4 weeks.
C/O involuntary movements of the RUE and twitching of the eyebrows.
EXAMINATION :
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.
OBSERVATION :
There are ill-defined, hypointense areas on the T1 Weighted images in the left high parietal region involving the grey matter. This is seen to turn heterogeneously hyperintense on the proton and T2 Weighted images with hypointense periphery. The lesion is predominantly hypointense on the Flair images. There is surrounding white matter edema with mass effect, effacement of the adjacent sulci and compression and inferior displacement of the body of the left lateral ventricle.
A lacunar infarct (isointense to CSF on all the pulse sequences)/cystic metastasis is noted in the frontal deep white matter bilaterally.
The right lateral and third ventricles are normal. There is slight fullness of the fourth ventricle with prominence of the cerebellar folia bilaterally.
The basal cisternal spaces are unremarkable. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.
Incidental note is made of left maxillary sinusitis.
IMPRESSION :
In a known C/O Ca breast the MRI features are suggestive of metastasis in the left parietal region and ? cystic metastasis/ ? lacunar infarcts in both frontal regoins.
A contrast enhanced scan would be worthwhile.