sb/ke/nl/rg.
Date : 00.00.00

Name of the Patient : Abc XyzMalmn / F / 30 yrs.
Referred by : Dr. Abc Xyzbar.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O high grade fever with headaches and altered sensorium since 00.00.00.
H/O delivery of a still born baby on 00.00.00 with bladder continence and loss of vision since then.
CSF s/o Tuberculous meningitis.
Now C/O paraparesis with multiple cranial nerve palsies.

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.

5 mm thick T1 Weighted and 3 mm thick T2 Weighted sagittal images.

OBSERVATION :

There is an ill-defined, hypointense signal on the T1 Weighted images in the genu of the corpus callosum and along the frontal cortex in the parafalcine regions bilaterally. This lesion appears hyperintense on the proton, T2 Weighted and FLAIR images.

There is a hyperintense signal, better appreciated on the FLAIR images in the subdural space at the right parietal convexity. This lesion may represent basal exudates, in the given clinical setting. Similar signal is also noted in the anterior interhemispheric fissure.




There is mild dilatation of both the lateral and third ventricles. The fourth ventricle is normal. Fluid levels are noted in the occipital horns bilaterally with increased signal,
in the atrium and occipital horn of the right lateral ventricle which may represent debris.

There is slight effacement of the sulcal spaces in the cerebral hemispheres bilaterally, more on the left side.

Intermediate signal intensity is seen in the suprasellar cistern on the T1 Weighted images and would represent exudates.

The basal cisternal spaces are slightly prominent. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.

Inflammatory changes are noted in the maxillary antra bilaterally.

IMPRESSION :

1. Altered signal in the genu of the corpus callosum and along the frontal cortex in the parafalcine regions bilaterally may represent ischemic changes, in the given clinical setting of tuberculous meningitis.

2. Altered signal in the subdural space at the right parietal convexity and in the anterior interhemispheric fissure and suprasellar cistern may represent exudates, in the given clinical setting.

3. Mild dilatation of both the lateral and third ventricles. Fluid levels in the occipital horns bilaterally with increased signal, in the atrium and occipital horn of the right lateral ventricle may represent debris and may suggest ventriculitis.

A contrast enhanced scan is essential.

As compared to the previous CT Scan dated 00.00.00, there is slight increase in the size of ventricles.