Name of the Patient : Abc Xyzvati Ylmn / F / 25 yrs.
Referred by : Dr. Abc Xyzrnad.
Examination : M.R.I. of the Brain.
CLINICAL PROFILE :
Known C/O TB Meningitis with hydrocephalus. VP Shunt was done on 00.00.0000.
C/O fever with chills, disorientation and convulsions.
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.
There is an ill-defined, hyperintense signal on the proton, T2 Weighted and FLAIR images in the cortex and subcortical white matter in the left fronto-temporal region and right frontal and temporal regions. These lesions appear hypointense to normal white matter on the T1 Weighted images and most likely represent ischemic changes probably due to vasculitis.
Similar signal is noted along the left high parietal parafalcine region and in the pons.
Hyperintense signal on the proton, T2 Weighted and FLAIR images in the periventricular white matter in the frontal regions bilaterally may represent periventricular CSF ooze.
There is mild to moderate dilatation of both the lateral and the third ventricles. The fourth ventricle is slightly full.
Soft tissue is noted in the suprasellar cistern which may represent exudates in the given clinical setting.
The rest of the basal cisternal spaces are unremarkable. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.
The left cerebral peduncle is slightly atrophied, ? due to Wallerian degeneration.
The tip of the shunt tube is noted in the right lateral ventricle with a right parietal burr hole.
Inflammatory changes are noted in the right maxillary sinus, left frontal sinus and in the ethmoidal air cells on the right.
1. Post-shunt status with the tip of the shunt tube in the right lateral ventricle.
2. Altered signal in the cortex and subcortical white matter in the left fronto-temporal region, right frontal and temporal regions, left high parietal parafalcine region and in the pons most likely represent ischemic changes probably due to vasculitis, in a known C/O TB Meningitis.
3. Altered signal in the periventricular white matter in the frontal regions bilaterally may represent periventricular CSF ooze.
3. Soft tissue lesion in the suprasellar cistern may represent exudates, in the given clinical setting.
4. Moderate communicating hydrocephalus.
As compared to the previous CT Scan dated 00.00.0000, the patient is now post-shunt status with slight decrease in the size of the ventricles.