sb/ke/rg.

Name of the Patient : Abc XyzMerclmn / M / 67 yrs.
Referred by : Dr. Abc Xyztrak / Dr. Abc Xyzrikh.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O diplopia with squint in the left eye and drop attacks (4 episodes) since 2 years.
Known hypertensive/diabetic.

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.

3 mm thick T1 Weighted and STIR coronal images.

OBSERVATION :

There are small bright foci, best appreciated on the FLAIR coronal images in the subcortical white matter in the frontal regions bilaterally. These lesions appear isointense to normal white matter on the T1 Weighted images and most likely represent ischemic changes.

There is slight fullness of both the lateral and the third ventricles. The fourth ventricle is normal. There is slight prominence of the cerebral cortical sulci and 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.

The sella and the perisellar region are unremarkable. The right optic nerve shows normal signal. There is increase in the perioptic CSF along the left optic nerve which appears slightly smaller in diameter as compared to the right. The visualized orbits and orbital apex is unremarkable.
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IMPRESSION :

1. Small bright foci in the subcortical white matter in the frontal regions bilaterally most likely represents ischemic changes.

2. Increase in the perioptic CSF along the left optic nerve with slight decrease in diameter of the left optic nerve
as compared to the right may suggest left optic nerve atrophy.