Name of the Patient : Abc Xylmn / F / 19 yrs.
Referred by : Dr. Abc Xyztcheswala.
Examination : M.R.I. of the Brain.
CLINICAL PROFILE :
H/O seizures since 2 months.
H/O fever with chills prior to onset.
M.R.I of the brain was performed using the following parameters :
5 mm thick T1 Weighted, proton and T2 Weighted axial images.
3 mm thick T2 Weighted coronal images.
5 mm thick FLAIR coronal images.
After administration of contrast the following parameters were used :
5 mm thick T1 Weighted axial images and 4 mm thick T1 Weighted coronal images with magnetization transfer.
5 mm thick T1 Weighted sagittal images.
There is an ill-defined, hyperintense signal on the proton, T2 Weighted and FLAIR images in the subcortical white matter in the left frontal region, around the precentral gyrus. This lesion appears hypointense on the T1 Weighted images.
Both the lateral, third and the fourth ventricles are normal. The basal cisternal spaces are unremarkable. There is slight prominence of the cerebral cortical sulci and the cerebellar folia bilaterally. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.
After administration of contrast, there is patchy enhancement within this lesion. No obvious meningeal enhancement is noted.
Enhancing lesion in the left frontal region as described, is not specific for a single etiology.
The differential diagnosis may include :
a. Granulomas like tuberculomas.
b. Neoplasia like astrocytomas.
The possibility of this lesion representing a vascular lesion seems less likely.
A follow-up study may be worthwhile.