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Name of the Patient : Abc Xyzar Palmn / M / 75 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.
CLINICAL PROFILE :
C/O sudden onset of loss of vision on 00.00.0000.
C/O hearing loss on the right side and decreased hearing on the left side.
Known hypertensive.
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 coronal images.
3 mm thick STIR coronal images through the optic nerves.
OBSERVATION :
There is an ill-defined hyperintense signal on the proton, T2 Weighted and FLAIR images along the cortex and subcortical white matter in the left parieto-occipital, parafalcine region. This lesion appears hypointense to normal white matter on the T1 Weighted images and most likely represents a recent ischemic lesion. Resultant slight sulcal space effacement is noted.
There is a CSF intensity lesion on all the pulse sequences along the right temporo-parietal cortex which represents an area of cystic encephalomalacia, most likely a sequelae of a previous vascular insult. Underlying white matter hyperintense signal on the proton, T2 Weighted and FLAIR images would represent gliotic changes. Resultant dilatation of the posterior body, atrium and occipital horn of the right lateral ventricle is noted.
There are ill-defined, hyperintense areas on the proton, T2 Weighted and FLAIR images in the periventricular white matter bilaterally and in bilateral centrum semiovale, which most likely represent ischemic changes.
Lacunar infarcts are noted in the pons, right thalamus, lentiform nuclei and external capsular regions bilaterally and in the parietal deep white matter bilaterally.
There is mild to moderate dilatation of both the lateral and third ventricles. The fourth ventricle is normal. There is slight prominence of the cerebral cortical sulci, cerebellar folia and the basal cisternal spaces bilaterally. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.
The visualized optic nerves appear normal in the course and signal characteristics, bilaterally.
Inflammatory changes are noted in the right maxillary antrum.
IMPRESSION :
1. Altered signal along the cortex and subcortical white matter in the left parieto-occipital, parafalcine region most likely represents a recent ischemic lesion.
2. An area of cystic encephalomalacia along the right temporo-parietal cortex, most likely the sequelae of a previous vascular insult.
3. Altered signal in the periventricular white matter bilaterally and in bilateral centrum semiovale most likely represents ischemic changes.
4. Lacunar infarcts in the pons, right thalamus, lentiform nuclei and external capsular regions bilaterally and in the parietal deep white matter bilaterally.
5. Cerebral cortical and cerebellar atrophy.