Name of the Patient : Abc Xyzh Bhatwalmn / M / 60 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.
CLINICAL PROFILE :
C/O swelling over the left side of the face with diplopia since 15 days.
M.R.I of the brain with orbits was performed using the following parameters :
5 mm thick T1 Weighted, proton and T2 Weighted axial images.
3 mm thick T1 Weighted and STIR coronal images.
5 mm thick FLAIR coronal images.
There are ill-defined hyperintense areas on the proton and T2 Weighted images in the subcortical and deep white matter in the posterior parietal regions bilaterally and the right frontal region. These lesions appear iso to hypointense to the normal white matter on the T1 Weighted images and most likely represent ischemic changes.
There is an intermediate signal intensity lesion on the T1 Weighted images in the left cavernous sinus, extending upto the left orbital apex. This lesion appears predominantly hypointense on the T2 Weighted and STIR images. The cavernous segment of the left internal carotid artery shows normal flow void signal.
The right cavernous sinus, sella and the suprasellar region are unremarkable. The optic nerves on either side also show normal signal intensity.
There is mild fullness of both the lateral ventricles. The third and the fourth ventricles are normal. There is slight prominence of the cerebral cortical sulci and cerebellar folia bilaterally.
The basal cisternal spaces are unremarkable. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.
Inflammatory changes are noted in the maxillary sinuses bilaterally and the right mastoid air cells.
The right middle and inferior nasal turbinates appear slightly hypertrophied.
1. Altered signal in the subcortical and deep white matter in the posterior parietal regions bilaterally and the right frontal region most likely represent ischemic changes.
2. Lesion in the left cavernous sinus, extending upto the left orbital apex as described is not specific for a single etiology. This most likely represents an inflammatory lesion, probably a pseudotumor.
A contrast enhanced scan would be worthwhile.