ke/sb/rg/nl
Name of the Patient : Abc Xyz D. Vlmn / M / 67 yrs.
Referred by : Dr. Abc Xyztrak.
Examination : M.R.I. of the Brain.
CLINICAL PROFILE :
C/O memory impairment.
C/O left sided Webers syndrome.
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.
3 mm thick T2 Weighted coronal images.
5 mm thick T1 Weighted sagittal images.
OBSERVATION :
There is an ill-defined, hyperintense area in the right occipital cortex and the subcortical white matter on the proton, T2 Weighted and FLAIR images. This area appears hypointense to normal grey matter on the T1 Weighted images. Few hyperintense areas are seen within this lesion on the T1 Weighted images and are seen to bloom on the Gradient images and may represent altered blood/calcification.
Lacunar infarcts (isointense to CSF on all the pulse sequences) are noted in the right cerebellar hemisphere, pons, left cerebral peduncle and in the parathird ventricular region, bilaterally (larger on the left side), in the thalamus.
Ill-defined, hyperintense areas on the proton, T2 Weighted and FLAIR images in the posterior parietal periventricular white matter on the left may represent ischemic changes.
There is mild fullness of both the lateral and the third ventricles. The fourth ventricle is normal. The basal cisternal spaces are prominent. There is slight prominence of the cerebral cortical sulci and cerebellar folia bilaterally. There is no shift of the midline structures. The vertebro-basilar system is ectatic.
IMPRESSION :
1. An old infarct in the right occipital cortex with ? old haemorrhage/calcification.
2. Lacunar infarcts in the right cerebellar hemisphere, pons, left cerebral peduncle and in the left parathird ventricular region bilaterally (larger on the left side), in the thalamus.
3. Altered signal in the posterior parietal periventricular white matter on the left may represent ischemic changes.
4. Cerebral and cerebellar atrophy.
As compared to the previous MRI dated 00.00.0000 (scan no:00002), the lesion in the right occipital cortex now shows evidence of encephalomalacic changes.
Lacunar infarcts are noted in the brainstem and thalami as described.