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hs/sb/rg/nl

Name of the Patient : Abc XyzKarmalmn / M / 46 yrs.
Referred by : Dr. Abc Xyzhacker / Dr. Abc Xyzrani.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O cerebellar haemangioblastoma with hydrocephalus.
V.P.Shunt was done on 00.00.00 with posterior fossa craniectomy on 00.00.00 for excision of tumor. Received Radiotherapy (31 sittings)
For Follow up to r/o residual/recurrent SOL.

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 T1 Weighted and FLAIR coronal images.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There are post-operative changes with susceptibility artifacts in the posterior fossa with posterior fossa decompression.

There is still seen an approximately 1.5 cms diameter sized hyperintense, nodular lesion on the T1 Weighted images in the left cerebellar hemisphere, superiorly near the midline. This lesion appears relatively hypointense on the T2 Weighted images. A peripheral, hypointense rim is also noted.

There is an ill-defined, hypointense area on the T1 Weighted images in the left cerebellar hemisphere posterior to the fourth ventricle and around the above described lesion. This is seen to turn hyperintense on the proton, T2 Weighted and FLAIR images.



There is resultant dilatation of the fourth ventricle and this lesion may
represent an area of cystic encephalomalacia, the result of previous surgery.

A small right frontal burr hole is noted with a ventriculostomy tube tract in the right frontal region. The tip of the shunt tube is noted in the right lateral ventricle.

A sliver of fluid is seen over the cerebral hemispheres bilaterally and along the cerebellar hemispheres (right more than left). These are slightly hyperintense to CSF on all the pulse sequences and may represent subdural hygromas. There is resultant thickening of the meninges in that region.

Both the lateral and the third ventricles are normal. The basal cisternal spaces are unremarkable. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.

Inflammatory changes are noted in the mastoid air cells (right more than left).

IMPRESSION :

The MRI features are suggestive of :

1. Post-operative status.

2. A 1.5 cms diameter sized nodular lesion in the left cerebellar hemisphere, near the midline may represent a residual lesion.

3. An area of cystic encephalomalacia in the left cerebellar hemisphere posterior to the fourth ventricle, the result of previous surgery.
..3/.









- 3 - Scan-00002


4. A small right frontal burr hole with a ventriculostomy tube tract in the right frontal region, with the tip of the shunt tube in the right lateral ventricle.

5. A sliver of collection over the cerebral hemispheres
bilaterally and along the cerebellar hemispheres (right more than left) and these may represent subdural hygromas.

If clinically indicated a contrast enhanced scan would be worthwhile.

As compared to the previous MRI (study no.00007) dated 00.00.0000, there is no significant change.





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