sb/hs/nl/rg.

Name of the Patient : Abc Xyz A. Shlmn / F / 18 yrs.
Referred by : Dr. Abc Xyzidhungat.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O headaches with visual defect on the left side.

EXAMINATION :

M.R.I of the brain was performed using the following parameters :

5 mm thick T1 Weighted, proton and T2 Weighted axial images.

4 mm thick T2 Weighted and 5 mm thick Fast Scan (T2 *) coronal images.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is evidence of a fairly large, 3.5 x 5.5 x 3.5 cms sized well-marginated mass lesion in the right parieto-occipital, parafalcine region. This lesion is iso to hypointense to normal grey matter on the T1 Weighted images and appears relatively hypointense on the proton and T2 Weighted images. There is perilesional edema with effacement of the sulcal spaces in the right temporo-parieto-occipital region. The occipital horn, atrium and temporal horn of the right lateral ventricle are compressed and displaced anteriorly by the lesion. There is indentation on the upper brainstem by the right medial temporal lobe, with effacement of the right ambient cistern. Shift of the midline structures to the left is noted.

There is mild fullness of both the lateral ventricles. The fourth ventricle is normal. The rest of the basal cisternal spaces are unremarkable. No obvious vascular anomaly is identified on this study.


Inflammatory changes are noted in the right maxillary antrum.

IMPRESSION :

A fairly large, 3.5 x 5.5 x 3.5 cms sized mass lesion in the right parieto-occipital, parafalcine region with signal characteristics and mass effect as described, most likely represents a tuberculoma (probably a conglomeration of multiple smaller lesions).

The possibility of this being an extra-axial lesion like a meningioma is less likely.

A contrast enhanced scan may be worthwhile.