sb/ke/nl/rg.
Date : 00.00.00
Name of the Patient : Abc XyzS. Chlmn / F / 58 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.
CLINICAL PROFILE :
C/O behavioural changes since 15 days.
H/O diarrhea prior to this.
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 Fast Scan (T2 *) coronal images.
OBSERVATION :
There is seen an approximately 3.1 x 2.8 x 2.2 cms sized, well-marginated, hyperintense mass lesion (with few hypointense areas within) on the T1 Weighted images in the left deep temporal region. A part of this lesion appears hypointense on the proton and T2 Weighted images with the bulk of the lesion remaining hyperintense on the T2 Weighted and FLAIR images. A hypointense rim, more pronounced on the Fast Scan (T2 *) images is noted around the lesion. There is mild perilesional edema and indentation on the frontal horn of the left lateral ventricle.
A lacunar infarct (isointense to CSF) is noted in the periventricular white matter in the right fronto-temporal region with focal dilatation of the frontal horn of the right lateral ventricle. Periventricular white matter hyperintense signal on the T2 Weighted and FLAIR images in the right fronto-temporal region may represent gliotic changes.
Ill-defined hyperintense areas on the proton, T2 Weighted and FLAIR images in the right globus pallidus, the right thalamus and left cerebral peduncle may represent ischemic changes.
The third and the fourth ventricles are normal. There is slight prominence of the cerebral cortical sulci, cerebellar folia and the basal cisternal spaces bilaterally. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.
Incidentally noted is an empty sella.
IMPRESSION :
1. An approximately 3.1 x 2.8 x 2.2 cms sized, mass lesion in the left deep temporal region follows the signal characteristics of intracellular and extracellular methemoglobin and represents a subacute hematoma.
2. A lacunar infarct in the periventricular white matter in the right fronto-temporal region with perilesional gliotic changes.
3. Altered signal in the right globus pallidus, the right thalamus and left cerebral peduncle may represent ischemic changes.