sb/bv/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzakant Halmn / M / 42 yrs.
Referred by : Dr. Abc Xyzidhungat.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

Immuno compromised patient with altered sensorium and slurred speech since 00.00.0000.
Patient is HIV +ve.

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.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There are lacunar infarcts (isointense to CSF on all the pulse sequences) in the left lentiform nucleus.

There are small bright foci on the proton, T2 Weighted and FLAIR images in the subcortical white matter in the frontal and parietal regions bilaterally. These lesions appear nearly isointense to normal white matter on the T1 Weighted images.

Ill-defined, hyperintense signal on the proton, T2 Weighted and FLAIR images is noted in the periventricular white matter in the frontal regions bilaterally.

There is mild dilatation of both the lateral, third and fourth ventricles. There is slight prominence of the cerebral cortical sulci and cerebellar folia bilaterally. The basal cisternal spaces are unremarkable. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.
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Note is made of inflammatory changes within the sphenoid sinus extending into the ethmoidal air cells, maxillary sinuses bilaterally and in the mastoid air cells.

IMPRESSION :

1. Altered signal in the subcortical white matter in the frontal and parietal regions bilaterally are ? ischemic lesions ?? granulomas (more likely the later)

2. Altered signal in the periventricular white matter in the frontal regions bilaterally may either represent ischemic changes or may represent periventricular CSF ooze.

3. Mild cerebral and cerebellar atrophy.

4. Mild dilatation of the ventricular system.

5. Inflammatory changes within the sphenoid sinus extending into the ethmoidal air cells, maxillary sinuses and in the mastoid air cells bilaterally.

As compared to the previous MRI dated 00.00.0000 (Study No.00003), there is slight increase in the size of the ventricles on the present study.