ke/bv/rp/nl







Name of the Patient : Abc Xyzon G. Ilmn / M / 82 yrs.
Referred by : Dr. Abc Xyzrikh.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O left sided weakness.

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

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is a small hypointense area on the T1 Weighted images in the posterior limb of the right internal capsule which is seen to turn hyperintense on the proton, T2 Weighted and Fast Scan images. This is intensely hyperintense on the diffusion images and would represent an area of infarction probably of recent origin (se/im:107/12, 102/12, 104/10, 103/12).

There is an ill-defined area in the left fronto-parietal region which is seen to follow CSF signal intensity on all the pulse sequences. Hyperintense areas on the proton, T2 Weighted and FLAIR images would represent gliotic changes. There is slight prominence of the sulcal spaces in that region and this lesion in toto would represent an area of cystic encephalomalacia.






There are hyperintense areas on the proton, T2 Weighted and FLAIR images in the fronto-parietal white matter and the cerebellar hemispheres bilaterally. These are hypointense to normal white matter on the T1 Weighted images and are probably ischemic in etiology.

Lacunar infarcts (isointense to CSF on all the pulse sequences) are noted in the cerebellar hemispheres bilaterally, within the pons and left corona radiata and bilateral centrum semiovale. Gliotic changes are seen adjacent to few of these lesions. Prominent perivascular spaces are seen in the thalami on either side.

There is mild fullness of the ventricular system, with thinning of the corpus callosum.

There is prominence of the cerebral cortical sulci. The basal cisternal spaces are unremarkable. There is no shift of the midline structures. No obvious vascular anomaly is identified on this scan.

Incidental note is made of inflammatory changes in the left maxillary sinus and ethmoidal air cells and the sphenoid sinus.

Both eyes are aphakic.

Note is made of an empty sella.

IMPRESSION :

1. An area of infarction (probably of a recent origin) in the posterior limb of the right internal capsule.

2. An area of cystic encephalomalacia in the left fronto-parietal region .
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3. Altered signal intensity areas in the fronto-parietal white matter and the cerebellar hemispheres bilaterally are probably ischemic in etiology.

4. Lacunar infarcts in the cerebellar hemispheres bilaterally, within the pons and left corona radiata and bilateral centrum semiovale.

5. Cerebral and cerebellar atrophy.