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

CLINICAL PROFILE :

C/O left hemiparesis.
Known hypertensive. Previous MRI s/o a hyperacute pontine bleed.
For follow-up.

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 coronal images.

OBSERVATION :

There is still seen an approximately 1.6 x 1.8 x 2.1 cms sized hypointense 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 slightly hyperintense to the normal white matter on the T1 Weighted images and turns hypointense on the proton, T2 Weighted and FLAIR images suggesting an acute hematoma. There is perilesional edema with bulging of the contour on the right of the pons and compression 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.

There is mild dilatation of both the lateral and the third ventricles, due to compression on the fourth ventricle and the acqueduct. There is prominence of the cerebral cortical sulci and the basal cisternal spaces bilaterally. There is mild bulge of the midline to the left. No obvious vascular anomaly is identified on this study.

Inflammatory changes are seen in the maxillary sinus bilaterally, ethmoidal air cells and sphenoid sinus.

IMPRESSION :

As compared to the previous MRI (study no:00000) dated : 00.00.0000 there is slight increase in the mass effect on the present study with compression of the fourth ventricle and mild dilatation of both the lateral and third ventricles.



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