Name of the Patient : Abc Xyza Tlmn / F / 5 yrs.
Referred by : Dr. Abc XyzSengupta.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O delayed milestones, with RUE weakness.

EXAMINATION :

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

5 mm thick T1 Weighted and T2 Weighted axial images.

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

3 mm thick T2 Weighted coronal images.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There are areas which are near isointense to CSF on all the pulse sequences within the occipital lobes bilaterally, left fronto-parieto-temporal lobes and right fronto-parietal lobes. These are surrounded by areas of hypointensity on the T1 Weighted images which turn hyperintense on the T2 Weighted and FLAIR images and would most likely represent gliotic changes. There is ex-vecuo dilatation of the occipital horn and atrium of the left lateral ventricle. There is slight fullness of the occipital horn and atrium of the right lateral ventricle. These areas in toto would represent areas of cystic encephalomalacia. Also seen is a paucity of the periatrial white matter with crowding of the sulci [these are seen to nearly abut the atria and occipital horn of both the lateral ventricles].








There is slight thinning of the posterior body and splenium of the corpus callosum. The left cerebral hemisphere appears smaller as compared to the right [hemiatrophy].

The third and fourth ventricles are normal. The basal cisternal spaces are unremarkable. There is no shift of the midline structures. No obvious vascular anomaly is identified on this scan.

IMPRESSION :

The MRI features are suggestive of areas of cystic encephalomalacia within the occipital lobes bilaterally, left fronto-parieto-temporal lobes and right fronto-parietal lobes. These would most likely the result of a hypoxic-ischemic insult [periventricular leukomalacia].