Name of the Patient : Abc Xyzen M. Nanalmn / F / 77 yrs.
Referred by : Dr. Abc Xyzdar.
Examination : M.R.I. of the Brain.
CLINICAL PROFILE :
Alleged H/O vehicular accident 4 days ago.
C/O giddiness with a semiconscious state since 2 days.
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.
There is a large ill-defined hypointense area on the T1 Weighted images in the left temporo-fronto-parietal lobes. This is seen to turn hyperintense on the FLAIR, proton and T2 Weighted images. Few hyperintense areas are seen within this lesion on the T1 Weighted images which are seen to turn hypointense on the proton and T2 Weighted images and bloom on the Fast Scan (T2 *) images and would represent altered blood. Edema is also seen to encroach into the posterior limb of the internal capsule, the external capsule and left lentiform nucleus on the left side. There is mass effect with effacement of the adjacent sulci, compression upon the body of the left lateral and the third ventricle and shift of the midline structures to the right. Mild effacement of the perimesencephalic cistern on the left is noted.
A small sliver of extracerebral collection (probably subdural) which is hyperintense on all the pulse sequences is seen to overlie the cerebral hemispheres bilaterally, right more than left and would represent extracerebral hematomas.
- 2 - Scan-00004
The right and the fourth ventricles are normal. No obvious vascular anomaly is identified on this study.
Incidental note is made of subgaleal contusions/edema in the right fronto-temporal region and air fluid level in the right maxillary sinus and right frontal sinus (probably haemorrhage in the given clinical setting). Inflammatory changes/blood is seen within the mastoid air cells.
In a known C/O trauma, the MRI features are suggestive of :
1. A large haemorrhagic contusion in the left temporo-fronto-parietal lobes as described.
2. Extracerebral hematomas (probably subdural) overlying the cerebral hemispheres bilaterally, right more than left.