Name of the Patient : Abc Xyzmal lmn / M / 70 yrs.
Referred by : Dr. Abc Xyzare.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O right sided weakness and speech disturbances.

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 6 mm thick Fast Scan (T2 *) coronal images.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

Lacunar infarcts (iso to hyperintense to CSF) are seen within the thalami, corona radiata and centrum semiovale bilaterally.

There are diffuse, ill-defined, hyperintense areas on the proton, T2 Weighted and FLAIR images in the periventricular white matter,
corona radiata and centrum semiovale bilaterally. These lesions appear iso to hypointense to normal white matter on the T1 Weighted images.

There is mild dilatation of both the lateral, third and the fourth ventricles. There is prominence of the cerebral cortical sulci, cerebellar folia and basal cisternal spaces bilaterally.

There is no shift of the midline structures. There is ectasia of the vertebro-basilar system.

Inflammatory changes are seen in the ethmoidal air cells and frontal sinus. The normal lens is not seen within both globes (past H/O cataract surgery).
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IMPRESSION :

1. Lacunar infarcts within the thalami, corona radiata and centrum semiovale bilaterally.

2. Altered signal in the periventricular white matter, corona radiata and centrum semiovale bilaterally most likely represent ischemic changes. Binswangers disease should be ruled out.

3. Mild cerebral and cerebellar atrophy with mild dilatation of the ventricular system.