hs/ke/rg/nl

Name of the Patient : Abc Xyz Bolmn / M / 75 yrs.
Referred by : Dr. Abc Xyzndu.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O dysphagia since 2 days.
H/O right hemiplegia in 0000. Being operated for Ca mandible 10-15 years ago. Received Radiotherapy.
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.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

Diffuse areas of hypointensity on the T1 Weighted images which turn hyperintense on the proton, T2 Weighted, FLAIR and Fast Scan (T2 *) images are seen within the left fronto-parieto-occipital lobes and the posterior aspect of the left temporal lobe. A few of the areas within this lesion are near isointense to CSF and would represent cystic changes. These areas would represent encephalomalacic changes. There is ex-vacuo dilatation of the left lateral ventricle, more so of the atrium and occipital horn.

Hypointense areas on the T1 Weighted images which turn hyperintense on the proton, T2 Weighted and FLAIR images are seen within the fronto-parietal and periatrial white matter on the right side and are most likely ischemic in etiology.

Lacunar infarcts (iso to hyperintense to CSF) are seen within the right corona radiata and right thalamus.
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- 2 - Scan-00001


There is fullness of the third and the right lateral ventricles. There is prominence of the basal cisternal spaces, cerebral cortical sulci and cerebellar folia bilaterally. The fourth ventricle is normal.

Hyperintense signal is seen on all the pulse sequences within the lumen of the left internal
carotid artery and this may represent slow flow/thrombus.

There is no shift of the midline structures.

Note is made of an empty sella.

The left eye is aphakic. The normal lens in right eye is not visualized and may be the result of previous surgery for cataract.

IMPRESSION :

The MRI features are suggestive of :

1. Areas of encephalomalacia within the left fronto-parieto-occipital lobes and the posterior aspect of the left temporal lobe.

2. Areas of altered signal within the fronto-parietal and periatrial white matter on the right side are most likely ischemic in etiology.

3. Lacunar infarcts within the right corona radiata and right thalamus.

4. Slow flow/thrombus in the left internal carotid artery.