Name of the Patient : Abc Xyzen V. lmn / F / 50 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.
CLINICAL PROFILE :
C/O seizures since childhood. On anti-epileptics.
C/O diminished hearing bilaterally with slurred speech since 1 week.
M.R.I of the brain was performed using the following parameters :
5 mm thick T1 Weighted, Proton and T2 Weighted axial images.
3 mm thick T2 Weighted coronal images.
2.8 mm thick 3D SPGR coronal images.
There are small areas of hyperintensity on the proton and T2 Weighted images within the white matter in the fronto-parietal lobes bilaterally. These are iso to hypointense to normal white matter on the T1 Weighted images and are most likely ischemic in etiology.
A lacunar infarct (iso to hyperintense to CSF on all pulse sequences) within the head of the right caudate nucleus.
There is thickening of the gyri in the left frontal and temporal lobe. It however shows normal signal intensity. This may represent polymicrogyria/pachygyria anomaly.
There is prominence of the cerebral cortical sulci and cerebellar folia bilaterally.
There is mild fullness of both the lateral ventricles. The third and the fourth 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.
The MRI features are suggestive of :
1. Areas of altered signal within the white matter in the fronto-parietal lobes bilaterally are most likely ischemic in etiology.
2. A lacunar infarct within head of the right caudate nucleus.
3. Polymicrogyria/pachygyria anomaly in the left fronto-temporal lobe.