ke/bv/rg.
Name of the Patient : Abc Xyzmin lmn / M / 11 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.
CLINICAL PROFILE :
C/O seizures and left hemiparesis since 5 years.
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.
MR Cisternogram in the coronal plane.
OBSERVATION :
There is a large intra-axial mass lesion in the inferior vermis and the left cerebellar hemisphere which measures approximately 2.5 x 3.2 x 2.2 cms. This lesion shows an intermediate signal intensity in its inferior and medial aspect on the T1 Weighted images which is seen to turn heterogeneously hypointense on the T2 Weighted images. The supero-lateral portion of this lesion is cystic and is hypointense on the T1 Weighted images and turns hyperintense on the proton and T2 Weighted images. There is mass effect with compression upon the left postero-lateral aspect of the fourth ventricle.
There are hypointense areas in the right cerebral hemisphere on the T1 Weighted images which are seen to turn hyperintense on the proton, T2 Weighted and FLAIR images, especially along the cortical matter and may represent gliotic changes. Gross dilatation of the body of the right lateral and the third ventricles is noted.
The left lateral ventricle is also dilated. The basal cisternal spaces are unremarkable. There is no shift of the midline structures.
The calibre of the right internal carotid artery is decreased.
..2/.
- 2 - Scan-00005
IMPRESSION :
The MRI features are suggestive of :
1. A large intra-axial mass lesion in the inferior vermis and the left cerebellar hemisphere measuring approximately 2.5 x 3.2 x 2.2 cms. with mass effect. This is not specific for a single etiology. The differential diagnosis would include,
a. Astrocytoma.
b. Hemangioblastoma.
c. Medulloblastoma.
2. Alterd signal in the right cerebral hemisphere with gross dilatation of the body of the right lateral and the third ventricles would represent gliotic changes most probably the result of a previous ischemic insult.