Date : 00.00.00
sb/bv
Name of the Patient : Abc Xyzray L. Plmn / M / 65 yrs.
Referred by : Dr. Abc Xyzrges.
Examination: M.R.I. of the Brain.

CLINICAL PROFILE :

C/O giddiness with urinary incontinence.
Known hypertensive.

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.

OBSERVATION :

Lacunar infarcts are noted in the pons, centrally, bilateral thalami and lentiform nuclei and in the head of the left caudate nucleus.

There is an ill-defined, hypointense signal on the T1Weighted images in the white matter in the right frontal, parafalcine region. A part of this lesion follows CSF signal on all the pulse sequences and the rest of the lesion appears hyperintense on the proton, T2 Weighted and FLAIR images.

Ill-defined, hyperintense signal on the proton, T2 Weighted and FLAIR images is noted in the periventricular white matter bilaterally, bilateral centrum semiovale and in the subcortical white matter in the left fronto-parietal region.

Slow flow/thrombus is seen in the right vertebral artery.

There is mild dilatation of both the lateral and third ventricles. The fourth ventricle is normal. There is slight prominence of the cerebral cortical sulci, cerebellar folia and basal cisterns billaterally. There is no midline shift.



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IMPRESSION :

1. Lacunar infarcts in the pons, centrally, bilateral thalami and lentiform nuclei and in the head of the left caudate nucleus.

2. Altered signal in the white matter in the right frontal, parafalcine region most likely represents an area of cystic encephalomalacia.

3. Altered signal in the periventricular white matter bilaterally, bilateral centrum semiovale and in the subcortical white matter in the left fronto-parietal region most likely represents ischemic changes. In view of the H/O hypertension, Binswangers disease should be ruled out.

4. Slow flow/thrombus in the right vertebral artery.