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sb/ke/rg.

Name of the Patient : Abc Xyz Palmn / M / 72 yrs.
Referred by : Dr. Abc Xyzagwati.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

H/O left cholecystectomy done on 00.00.0000.
C/O seizures since 00.00.0000.

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.

FEW IMAGES SHOW PATIENT MOTION.

OBSERVATION :

There are ill-defined, hyperintense areas on the proton, T2 Weighted and FLAIR images in the thalami bilaterally. These areas appear isointense to normal gray matter on the T1 Weighted images and most likely represents ischemic changes.

There are CSF signal intensity areas on all pulse sequences in the right inferior frontal region with perilesional white matter hyperintense signal on the proton, T2 Weighted and FLAIR images. These changes represent an area of cystic encephalomalacia with perilesional gliotic changes.

An area of cystic encephalomalacia is also noted in the left centrum semiovale. Along the inferior margin of this lesion (along the supero-lateral wall of the midsegment of the body of the left lateral ventricle), there is an approximately 1.0 cms diameter sized signal-void area on all pulse sequences which blooms on the Fast Scan (T2 *) images and may represent a calcific focus.
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- 2 - Scan-00008


A lacunar infarct is noted in the periventricular white matter in the right frontal region.

There is mild dilatation of both the lateral ventricles. The third and the fourth ventricles are normal. The basal cisternal spaces are unremarkable. There is prominence of the cerebral cortical sulci and cerebellar folia bilaterally. There is no shift of the midline structures. The vertebro-basilar system is ectatic.

Inflammatory changes are noted in the paranasal sinuses and the mastoid air cells bilaterally.

IMPRESSION :

1. Altered signal in the thalami bilaterally most likely represents ischemic changes.

2. Altered signal in the right inferior frontal region represent an area of cystic encephalomalacia with perilesional gliotic changes ? the sequelae of previous contusion ?? previous ischemic lesion.

3. An area of cystic encephalomalacia in the left centrum semiovale with a calcific focus along its inferior margin (the possibility of the signal-void lesions representing residual haemosiderin seems less likely).

4. A lacunar infarct in the periventricular white matter in the right frontal region.

5. Pansinusitis with inflammatory changes in the mastoid air cells bilaterally.

6. Age related cerebral and cerebellar atrophy.
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