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sb/bv/rg.

Name of the Patient : Abc Xyzl lmn / M / 85 yrs.
Referred by : Dr. Abc Xyzagwati / Dr. Abc Xyzni.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O left hemiparesis.
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 :

There is seen an approximately 1.6 x 1.8 x 2.1 cms sized hyperintense lesion on the proton, T2 Weighted and FLAIR images in the pons, more to the right of the midline. This lesion appears nearly isointense to the normal white matter on the T1 Weighted images and blooms on the Fast Scan (T2 *) images suggesting a hyperacute to acute hematoma. There is mild perilesional edema. There is mild mass effect with bulging of the contour of the pons on the right side and effacement of the superior portion of the fourth ventricle.

There is volume loss in the left anterior temporal region with a hyperintense signal, best appreciated on the FLAIR images along the margin of the anterior temporal lobe in that region, most likely the sequelae of a previous vascular insult.

There are ill-defined, hyperintense areas on the proton, T2 Weighted and FLAIR images in the periventricular white matter bilaterally, right thalamus and in the corona radiata and centrum semiovale bilaterally which most likely represents ischemic changes.
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Dilated perivascular spaces are seen in the lentiform nuclei, centrum semiovale and corona radiata bilaterally.

Both the lateral and the third ventricles are normal. There is prominence of the cerebral cortical sulci and the basal cisternal spaces bilaterally. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.

Inflammatory changes are seen in the right maxillary sinus.

IMPRESSION :

1. An approximately 1.6 x 1.8 x 2.1 cms sized lesion
in the pons, more to the right of the midline
most likely represents a hyperacute to acute intracerebral
hematoma with surrounding mass effect.

2. Volume loss in the left anterior temporal region with altered signal along the margin of the anterior temporal lobe most likely the sequelae of a previous vascular insult.

3. Altered signal in the periventricular white matter bilaterally, right thalamus and in the corona radiata and centrum semiovale bilaterally most likely represent ischemic changes.

4. Cerebral cortical atrophy.

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