sb/ke/rg/nl

Name of the Patient : Abc XyzPurlmn / M / 22 yrs.
Referred by : Dr. Abc Xyzdar.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O left hemiparesis since 7-8 days.

EXAMINATION :

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

5 mm thick T1 Weighted, proton and T2 Weighted axial images.

4 mm thick FLAIR coronal images.

3 mm thick T2 Weighted coronal images.

The pPatient refused contrast administration.

OBSERVATION :

There is a diffuse, hyperintense signal on the proton, T2 Weighted and FLAIR images in the right fronto-temporo-parietal region, including the insular cortex. This lesion appears predominantly hypointense on the T1 Weighted images. There are focal hypointense lesions on the T1 Weighted images in the right basal ganglionic region and the right thalamus extending into the right midbrain, which appears hyperintense on the proton, T2 Weighted and FLAIR images. There is resultant effacement of the cortical sulcal spaces, distortion of the upper brain-stem axis, transtentorial herniation of the right medial temporal pole and indentation on the right lateral and third ventricles with shift of the midline structures to the left.

The left lateral and the fourth ventricles are normal. No obvious vascular anomaly is identified on this study.

Inflammatory changes are noted in the left maxillary sinus.
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IMPRESSION :

Altered signal in the right fronto-temporo-parietal region with suspected focal lesions in the right basal ganglionic region and the right thalamus as described are not specific for a single etiology. A diffuse neoplasm like a glial cell tumor or focal granulomas in the right basal ganglionic region and in the right thalamus with perilesional edema may be considered as a differential diagnosis.

A contrast enhanced scan is essential.