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Name of the Patient : Abc Xyzaraj Almn / M / 61 yrs.
Referred by : Dr. Abc Xyzmpat.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

Known C/O multiple CVA. Detected to have an acute intracerebral hematoma in the left thalamus on 00.00.0000.
For follow up.

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 seen an approximately 2.2 x 1.9 x 1.9 cms diameter sized, predominantly hyperintense lesion on the T1 Weighted images in the left thalamus, extending into the left cerebral peduncle. This lesion appears more hyperintense on the proton, T2 Weighted and FLAIR images and shows a peripheral hypointense rim, best appreciated on the Fast Scan (T2 *) images. There is mild perilesional edema. This lesion would represent a late subacute hematoma.

Lacunar infarcts (iso to hyperintense to CSF) are seen within the white matter in the fronto-parietal lobes bilaterally.

Ill-defined hyperintense areas on the proton, T2 Weighted and FLAIR images are seen within the periventricular white matter, white matter in the fronto-parietal lobes bilaterally and the left temporal lobe and are most likely ischemic in etiology.

There is evidence of an extra-axial lesion which is nearly isointense to CSF on all the pulse sequences, antero-medial to the left temporal lobe, which may represent an arachnoid cyst.
..2/.



- 2 - Scan-00001


There is mild to moderate dilatation of both the lateral and the third ventricles. The fourth ventricle is normal.

There is mild prominence of the cerebral cortical sulci and the basal cisternal spaces bilaterally.

There is no shift of the midline structures.

IMPRESSION :

1. An approximately 2.2 x 1.9 x 1.9 cms diameter sized, lesion in the left thalamus, extending into the left cerebral peduncle follows signal characteristics of a late subacute hematoma.

2. Lacunar infarcts within the white matter in the fronto-parietal lobes bilaterally.

3. Altered signal within the periventricular white matter, white matter in the fronto-parietal lobes bilaterally and the left temporal lobe are most likely ischemic in etiology.

4. A CSF intensity, extra-axial lesion in the left temporal region most likely represent an arachnoid cyst.

4. Mild to moderate dilatation of both the lateral and the third ventricles with age related cerebral cortical atrophy.

As compared to the previous MRI dated 00.00.0000 (Study 00001), the left thalamic hamatoma is now in a late subacute stage. There is reduction in the perilesional edema and mass effect. The lacunar infarcts, ischemic lesions and the size of the ventricles is largely unchanged.


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