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Name of the Patient : Abc Xyzed Ralmn / M / 32 yrs.
Referred by : Dr. Abc Xyzbar.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O headaches, vomiting and weakness of the LLE.

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 loss of normal flow void signal in the superior sagittal sinus and the left transverse sinus. In place is noted an intraluminal, hyperintense signal on all the pulse sequences, suggesting a superior sagittal and left transverse sinus thrombosis. This intraluminal signal is not seen in the entire segment of the sinus, suggesting partial recanalization/partial thrombosis. Some of the superficial cortical veins in the high parietal regions bilaterally also show intraluminal signal, suggesting cortical venous thrombosis.

There are ill-defined, hyperintense areas on the proton, T2 Weighted and FLAIR images in the left parieto-occipital region and in the high parietal regions bilaterally. These areas appear predominantly hyperintense on the T1 Weighted images. There is evidence of subacute hemorrhage (patchy hyperintense signal on all the pulse sequences) within these lesions.






There is seen an approximately 2.9 x 1.2 x 1.6 cms sized well-defined, hyperintense lesion on all the pulse sequences in the right high frontal white matter. This lesion represents a late subacute hematoma. There is mild perilesional edema with slight sulcal space effacement in that region.

There is mild fullness of both the lateral and third ventricles. The fourth ventricle is normal. There is slight prominence of the cerebellar folia bilaterally. The basal cisternal spaces are unremarkable. There is no shift of the midline structures.

IMPRESSION :

1. Intraluminal signal in the superior sagittal and left transverse sinus and in some of the superficial cortical veins as described, suggests venous sinus thrombosis (partially recanalized superior sagittal sinus).

2. Altered signal in the left parieto-occipital region and in the high parietal regions bilaterally represents hemorrhagic venous infarcts in the given clinical setting.

3. An approximately 2.9 x 1.2 x 1.6 cms sized well-defined, lesion in the right high frontal white matter represents a late subacute hematoma.
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