ke/bv/nl/rg.

Name of the Patient : Abc Xyzajwalmn / F / 69 yrs.
Referred by : Dr. Abc Xyzagwati.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O left sided hemiplegia.

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.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is thickening of the gyri of the right cerebral hemisphere which is hypointense to normal grey matter on the T1 Weighted images which are seen to turn hyperintense on the T2 Weighted, Flair and Fast Scan (T2 *) images. Similar areas are also seen in the head of the caudate nucleus, lentiform nucleus and the thalamus on the right side and are suggestive of infarction.
There is a hypointense rim on the Fast Scan (T2 *) images in the right occipital region which probably represents haemorrhagic component. There is mass effect with uncal herniation/transtentorial herniation and effacement of the perimesencephalic cistern, compression of the body of the right lateral and third ventricles with shift of the midline structures to the left.

A lacunar infarct is seen in the left thalamus and left cerebellar hemisphere.

A hyperintense area is seen in the left cerebellar hemisphere on the proton, T2 Weighted and FLAIR images and probably represents an ischemic focus.
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There is dilatation of the body of the left lateral ventricle with hyperintense areas in the left periatrial deep white matter. This may represent CSF ooze.

There is fullness of the fourth ventricle with prominence of the cerebellar folia bilaterally.

There is absence of the normal flow void signal within the intracranial portion of the internal carotid artery on the right side and this may represent thrombus.

IMPRESSION :

1. Right global infarct involving the right cerebral hemisphere with a probable hemorrhagic component in the right occipital lobe.

2. Lacunar infarcts within the lentiform nucleus and thalamus on the left side.

3. Thrombus within the intracranial portion of the internal carotid artery on the right side.

As compared to the previous MRI (study no:00004) dated 00.00.0000, there is now a large right global infarct involving the right cerebral hemisphere.