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Name of the Patient : Abc Xyzw Minolmn / M / 69 yrs.
Referred by : Dr. Abc Xyzdar / Dr. Abc Xyzrdiwalla.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

H/O right frontal craniotomy on 00.00.0000 for right frontal meningioma with bleed.
Slight weakness of the LUE, LLE and slurring of speech still persists.
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 and Fast Scan (T2 *) coronal images.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is evidence of a right frontal craniotomy. Minimal epidural fluid and air beneath the craniotomy flap is the sequelae of previous surgery. Minimal, subdural haemorrhage is noted in the right temporo-parietal region, which is hyperintense on all the pulse sequences.

There is an ill-defined, hyperintense signal on the proton, T2 Weighted and FLAIR images in the right fronto-temporal region. This lesion appears predominantly hypointense on the T1 Weighted images. Ill-defined, hyperintense signal on the T1 Weighted images is noted within this lesion, anteriorly which represents hemoglobin breakdown products (subacute hemorrhage). A slightly more hyperintense signal on the proton, T2 Weighted and FLAIR images is noted in the right frontal region which may suggest cystic/necrotic changes.



There is sulcal space effacement in the right fronto-temporal region with bulge of the anterior falx to the left and posterior displacement and splaying of the frontal horns of the lateral ventricles bilaterally.

There is volume loss in the anterior temporal regions bilaterally.

The third and the fourth ventricles are normal. There is slight prominence of the cerebral cortical sulci in the left cerebral hemisphere and prominence of the cerebellar folia bilaterally. The basal cisternal spaces are unremarkable. No obvious vascular anomaly is identified on this study.

Susceptibility artifacts are noted at the operative site.

Inflammatory changes are noted in the mastoid air cells bilaterally.

IMPRESSION :

1. Post-operative status.

2. Diffuse altered signal in the right fronto-temporal region would represent residual edema (? residual tumor), subsequent to excision of the right frontal meningioma. Haemorrhagic foci within the lesion with cystic/necrotic changes as described may be the sequelae of previous surgery.

As compared to the previous MRI (study no:00008) dated 00.00.0000, there is reduction in the mass effect on the present study.

A contrast enhanced scan would be helpful to evaluate for tumor removal.









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