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Name of the Patient : Abc Xyzesh Gaolmn / M / 9 yrs.
Referred by : Dr. Abc Xyzdar.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

Alleged H/O from a height at 3.30 pm on 00.00.0000 with loss of consciousness.

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.

3 mm thick T1 Weighted and STIR coronal images through the orbits.

3 mm thick parasagittal oblique T1 Weighted images through the optic nerves.

5 mm thick T1 Weighted sagittal images

OBSERVATION :

There is a large area in the right frontal region which measures approximately 1.8 x 3.8 x 2.2 cms. This lesion is iso to hypointense to grey matter on the T1 Weighted images and turns hypointense on the proton and T2 Weighted images. The periphery of the lesion is hypointense on the T1 Weighted images and turns hyperintense on the proton, T2 Weighted and Flair images. This would represent serum with clot retraction and this lesion would represent an acute hematoma. There is minimal surrounding edema and mass effect with shift of the falx in the anterior frontal region to the opposite side. There is splaying of the frontal horns of the lateral ventricles.


Subtle hyperintense areas are seen on the proton, T2 Weighted and Flair images in the right frontal cortex and are hypointense to the white matter on the T1 Weighted images and would represent a hemorrhagic contusion.

There is suggestion of break of the lamina papyracea on the right side with fluid levels in the ethmoidal air cells, the maxillary sinuses and left mastoid air cells. There is also suggestion of break of the right temporal bone (se/im:105/6) and right lateral wall of orbit. This represents blood in the given clinical setting.

Hyperintense areas on the proton, T2 Weighted and Flair images in the right frontal subgaleal region around the right orbit and right cheek represents edema/contusion.

The optic nerves show normal signal intensity on the STIR images bilaterally. There is no mechanical compression of the right optic nerve.

Both the lateral, 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.

IMPRESSION :

1. An acute hematoma in the right frontal region measuring approximately 1.8 x 3.8 x 2.2 cms.

2. A hemorrhagic contusion in the right frontal cortex.

3. Fluid levels in the ethmoidal air cells, the maxillary sinuses and left mastoid air cells would represent blood in the given clinical setting.

4. Altered signal in the right frontal subgaleal region around the right orbit and right cheek represents edema/contusion.


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