sb/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyza lmn / M / 65 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O altered sensorium with inability to speak and loss of bladder/bowel control since 3-4 months.
H/O depression 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 coronal images.

3 mm thick T1 Weighted sagittal images.

OBSERVATION :

There are ill-defined hyperintense areas on the proton, T2 Weighted and FLAIR images in the periventricular white matter bilaterally predominantly in the fronto-parietal regions and in the centrum semiovale. These lesions appear hypointense on the T1 Weighted images and most likely represent ischemic changes.

The colliculi appear unremarkable.

There is mild dilatation of both the lateral, third and the fourth ventricles. There is prominence of the cerebral cortical sulci (especially in both frontal and temporal lobes) and cerebellar folia and basal cisternal spaces bilaterally.

There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.



There is seen an approximately 1.5 x 0.9 x 1.7 cms diameter sized well-defined, intermediate signal intensity lesion on the T1 Weighted images in the CSF space (intradural lesion) to the left of the midline, anteriorly at the C1-C2 level. This lesion appears relatively hypointense on the proton and T2 Weighted images. Mild indentation on the cervico-medullary junction is noted.

IMPRESSION :

1. Altered signal in the periventricular white matter bilaterally predominantly in the fronto-parietal regions and in the centrum semiovale most likely represent ischemic changes.

2. An approximately 1.5 x 0.9 x 1.7 cms diameter sized well-defined, lesion in the CSF space (intradural lesion) to the left of the midline, anteriorly at the C1-C2 level is not specific for a single etiology. A meningioma or a nerve sheath tumor are likely possibilities. The possibility of this lesion being a vascular lesion in relation to the left vertebral artery seems less likely.

A contrast enhanced scan would be worthwhile.

3. Mild cerebral and cerebellar atrophy.