ke/sb/nl/rg.
Name of the Patient : Abc Xyzlmn / M / 10 yrs.
Referred by : Dr. Abc Xyzwant.
Examination : M.R.I. of the Cervical Spine & Brain.
CLINICAL PROFILE :
C/O recurrent vomiting since 00.00.0000.
H/O being operated for C1-C2 neurofibroma on 00.00.0000 and reexplored for CSF leak on 00.00.0000.
EXAMINATION :
The cervical spine was scanned with :
4 mm thick T2 Weighted sagittal images.
5 mm thick T1 Weighted and Gradient axial images.
5 mm thick T1 Weighted coronal images.
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.
MR cisternogram was obtained in the sagittal plane.
OBSERVATION :
CERVICAL SPINE :
There are post-operative changes in the posterior soft tissues in the upper cervical region with a small posterior pseudomeningocele.
A large lobulated mass lesion is seen in the soft tissues of the neck on the right side extending over the C2 to C5 vertebral levels. This lesion is slightly hyperintense to muscle on the T1 Weighted images and turns hyperintense on the T2 Weighted images. The lesion is seen to extend into the C2-C3 and C3-C4 neural foramina on the right side encasing the right vertebral artery.
The cervical spinal cord at the C2 vertebral level shows a subtle hyperintense signal on the T2 Weighted and Gradient images which is isointense to normal cord on the T1 Weighted images suggestive of cord edema/ischemia. Slight decrease in calibre of the cord at the C2 level is also noted.
BRAIN :
There is moderate dilatation of both the lateral, third and fourth ventricles with dilatation of the aqueduct. Turbulent flow signal is noted in the superior portion of the fourth ventricle, aqueduct and posterior third ventricle.
Ill-defined, hyperintense areas are noted on the proton, T2 Weighted and FLAIR images in the periventricular white matter, bilaterally which represents transependymal seepage of CSF. There is slight thinning of the corpus callosum.
The basal cisternal spaces are unremarkable. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.
IMPRESSION :
CERVICAL SPINE :
1. Post-operative status.
2. In a known C/O neurofibroma the MRI features are suggestive
of residual neurofibroma in the soft tissues of the neck on the right side extending over the C2 to C5 vertebral levels with extensions as described and encasing the right vertebral artery.
..3/.
- 3 - Scan-00002
3. Altered cord signal at the C2 vertebral level suggests cord edema/ischemia.
As compared to the previous MRI dated 00.00.0000, the intraspinal component of the lesion at C1-C2 level is not visualized on the present study.
BRAIN :
1. Moderate communicating hydrocephalus with periventricular seepage.