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sb/hs/nl/rg.

Name of the Patient : Abc Xyzi N. Plmn / M / 68 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O involuntary movements of BUE and BLE and lower jaw.
H/O weakness in the LLE in October 0000, from which patient recovered.

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 are ill-defined, hyperintense areas on the proton, T2 Weighted and FLAIR images in the periventricular white matter bilaterally and in the frontal and parietal subcortical white
matter bilaterally. These areas appear iso to hypointense to normal white matter on the T1 Weighted images.

Prominent perivascular spaces are noted in the lentiform nuclei bilaterally.

Hyperintense signal on the T1 Weighted images is seen within the lentiform nuclei bilaterally and this may represent deposition of paramagnetic substances.

The superior colliculi appear slightly smaller in calibre. Progressive supranuclear palsy should be ruled out.

There is mild dilatation of both the lateral ventricles.

The third and the fourth ventricles are normal. There is slight 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.
..2/.





Inflammatory changes are noted in the right maxillary antrum.

IMPRESSION :

1. Altered signal in the periventricular white matter bilaterally and in the frontal and parietal subcortical white matter bilaterally most likely represents ischemic changes.

2. Hyperintense signal on the T1 Weighted images within the lentiform nuclei bilaterally and this may represent deposition of paramagnetic substances.

3. Mild cerebral cortical atrophy.



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