Name of the Patient : Abc Xyz lmn / F / 23 yrs.
Referred by : Dr. Abc Xyzikhalikar.
Examination : M.R.I. of the Brain.
CLINICAL PROFILE :
C/O weakness of the LUE and LLE with deviation of the angle of the mouth.
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.
After administration of contrast, the following parameters were used :
5 mm thick T1 Weighted axial and coronal images with
magnetization transfer.
5 mm thick T1 Weighted sagittal images.
OBSERVATION :
There is seen a well marginated, approximately 2.8 x 2.5 x 3.1 cms sized intensely enhancing mass lesion in the lower midbrain and pons, posteriorly. This lesion is iso to slightly hyperintense to normal grey matter on the T1 Weighted images but appears hyperintense on the T2 Weighted images and seems to be a conglomeration of multiple lesions. Perilesional hyperintense signal on the proton, T2 Weighted and FLAIR images in the brainstem, middle cerebellar peduncles and in the cerebellar hemispheres bilaterally may represent perilesional edema. Resultant effacement of the peripontine and perimesencephalic cisterns and the fourth ventricle is noted.
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The cerebellar tonsils are displaced slightly inferiorly.
There is mild dilatation of both the lateral and third ventricles.
There is no shift of the midline structures. No obvious vascular anomaly is identified on this scan.
There is no abnormal enhancement along the meninges.
Inflammatory changes are noted in the right middle ear cavity.
IMPRESSION :
An approximately 2.8 x 2.5 x 3.1 cms sized intensely enhancing mass lesion in the lower midbrain and pons, posteriorly follows the signal characteristics of a tuberculoma. This lesion is probably a conglomeration of multiple smaller lesions. Resultant mild obstructive hydrocephalus is noted.
The possibility of this lesion representing a neoplasm seems less likely.