Name of the Patient : Abc Xyzlmn / M / 50 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.
CLINICAL PROFILE :
C/O weakness of the LUE and LLE with slurred speech and semiconscious state since 2 weeks.
H/O stereotactic biopsy on 00.00.0000. HP s/o demyelinating pseudotumor.
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.
There are multiple, well-marginated, hypointense mass lesions on the T1 Weighted images, in both the cerebral hemispheres. These lesions appear hyperintense on the proton and T2 Weighted images but are only slightly more hyperintense as compared to CSF on the FLAIR images and vary in size from about 2.5 to 4.0 cms in their maximum transverse dimensions.
There is perilesional edema with sulcal effacement in these regions. Also seen is slight indentation upon the left lateral ventricle.
The right lateral and third ventricles are unremarkable. The fourth ventricle is normal. The basal cisternal spaces are unremarkable. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.
There is no obvious evidence of hemorrhage on this study.
Site of previous burrhole is noted in the left high parietal region.
Multiple, mass lesions in both the cerebral hemispheres, bilaterally, as described are not specific for a single etiology.
The stereotactic biopsy report was suggestive of a demyelinating pseudotumor.
Mutliple abscesses, multiple cystic metastasis/lymphoma may also be considered in the differential diagnosis.