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sb/ke/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzn lmn / F / 69 yrs.
Referred by : Dr. Abc Xyzmpat.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

H/O loss of consciousness since the morning of 00.00.00.
Known hypertensive.

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 and Fast Scan (T2 *) coronal images.

OBSERVATION :

There is seen a fairly large, approximately 4.5 x 7.5 x 5.5 cms sized mass lesion in the right deep temporal region with its epicentre in the right external capsular region. This lesion is of intermediate signal on the T1 weighted images and turns heterogeneously hyperintense on the proton, T2 Weighted and Flair images and represents a hyperacute to acute intracerebral hematoma. Peripheral, hyperintense signal on the proton and T2 Weighted images represents serum due to clot retraction. There is resultant effacement of the right Sylvian cistern and the cerebral cortical sulci in the right cerebral hemisphere, compression of the right lateral and third ventricles and shift of the midline structures to the left. Mild perilesional edema is also noted. The lesion extends inferiorly into the right cerebral peduncle with slight effacement of the fourth ventricle. There is a suggestion of intraventricular extension. The lesion extends upto the surface of the right temporal lobe with dissection into the subdural space over the right cerebral convexity. Superiorly the lesion extends into the right corona radiata.


There are ill-defined hyperintense areas on the proton, T2 Weighted and Flair images in the periventricular white matter bilaterally and in the head of the left caudate nucleus. These areas appear hypointense on the T1 Weighted images and most likely represent ischemic changes.

There is a linear, CSF signal intensity lesion with a peripheral hypointense rim on all the pulse sequences in the left external capsular region which most likely is the sequelae of previous intracranial hematoma.

The left lateral ventricle is normal. The basal cisternal spaces are unremarkable. The vertebro-basilar system is ectatic.

IMPRESSION :

The MRI features suggest an approximately 4.5 x 7.5 x 5.5 cms sized hyperacute to acute intracerebral hematoma in the right external capsular region with intraventricular extension and dissection into the subdural space over the right cerebral convexity. There is resultant significant mass effect as described.

Ischemic changes are noted in the periventricular white matter
bilaterally and in the head of the left caudate nucleus and capsular region, the sequelae of the previous intracranial hematoma in the left external capsular region.

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