ke/bv/rp/nl







Name of the Patient : Abc Xyzbai Madlmn / F / 63 yrs.
Referred by : Dr. Abc Xyzla.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O aneurysm. Operated for the same.
Patient is unconscious.

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 right frontal craniotomy with post-operative changes. Hyperintense signal on the T2 Weighted and FLAIR images is seen in the right fronto-parietal subgaleal region and the operative site (extra dural in location) and represents post-operative collection.

There is a large lesion in the right frontal lobe which measures approximately 5.2 X 5.3 X 4.8 cms. This lesion is predominantly hypointense with few hyperintense areas on the T1 Weighted images. This is seen to turn heterogeneously hypointense with few interspersed areas of hyperintensity on the proton, T2

Weighted and FLAIR images and blooms on the Fast scan (T2 *) images. These represents a subacute hematoma. There is surrounding edema with mass effect with effacement of the adjacent sulci, right sylvian fissure and quadrigeminal cistern on the right side. There is compression upon the body of the right lateral ventricle with shift of the midline structures to the left. The right middle cerebral artery is not well visualized. Some dilatation is identified in the proximal right middle cerebral artery. Anterior to this region is seen an intermediate signal intensity area on the T1 Weighted images which turns hyperintense on the proton and T2 Weighted images and may represent surgical packing material.

Intermediate signal intensity areas on the T1 Weighted images which are hyperintense on the proton, T2 Weighted and FLAIR images and bloom on the Fast scan (T2*) images are noted in both the lateral ventricles and represent intra-ventricular hemorrhage. Similar altered signal in the subarachnoid space is noted in the right fronto-temporal region and the left sylvian fissure. Layering is also see in the occipital horns.

There are hyperintense areas on the proton, T2 Weighted and FLAIR images in the left cerebellar hemisphere postero-inferiorly, left side of the pons, right cerebral peduncle and the left lentiform nucleus. These are hypointense to the normal white matter on the T1 Weighted images and are probably ischemic in etiology.

There is mild dilatation of the left lateral ventricle with altered signal in the periventricular and paraatrial white matter and may be ischemic in etiology.

Incidental note is made of inflammatory changes in the maxillary sinuses and the ethmoidal air cells bilaterally and the right mastoid air cells.
..3/.










- 3 - Scan-00002

IMPRESSION :

1. Post-operative status.

2. A large lesion measuring approximately 5.2 X 5.3 X 4.8 cms. in the right frontal lobe with surrounding edema and mass effect most probably represents a subacute hematoma.

3. Intraventricular and subarachnoid haemorrhage as described.

4. Altered signal intensity areas in the periventricular regions, left cerebellar hemisphere postero-inferiorly, left side of the pons, right cerebral peduncle and in the left lentiform nucleus are most probably ischemic in etiology.

No previous investigations were available for review/comparison.