sb/ke/nl/rg.
Date : 00.00.00

Name of the Patient : Abc XyzAli lmn / F / 40 yrs.
Referred by : Dr. Abc Xyzrani.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

Operated for a suprasellar and planumsphenoidal meningioma on 00.00.00. Patient developed right hemiparesis.

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 sagittal images.

3 mm thick T1 Weighted and STIR coronal images.

OBSERVATION :

There is evidence of a right frontal craniotomy with post-operative changes in the soft tissues in the right frontal region.

There is seen an ill-defined, hyperintense signal on the proton, T2 Weighted and FLAIR images in the inferior frontal cortex, bilaterally, right frontal cortex, left parathird ventricular region, left cerebral peduncle and in the posterior limb of the left internal capsule. This lesion appears hypointense on the T1 Weighted images.

Focal hyperintense signal on the T1 Weighted images in the left inferior frontal region, right frontal region, left parathird ventricular region and in the left cerebral peduncle represents hemoglobin breakdown products.

There is an ill-defined, hyperintense signal on the T1 Weighted images in the suprasellar cistern on the left, which remains hyperintense on the proton, T2 Weighted and STIR images. The pituitary stalk is not well-identified from the lesion which is seen to indent the optic chiasma to the left of the midline. The left optic nerve appears slightly atrophied and shows a hyperintense signal on the STIR images in its proximal segment. The pituitary gland is well identified on the present study. The cavernous sinuses on either side are unremarkable. The visualized right optic nerve shows normal signal.

There is mild dilatation of both the lateral, third and the fourth ventricles. There is slight prominence of the cerebral cortical sulci and cerebellar folia bilaterally. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.

IMPRESSION :

1. Post-operative status.

2. Altered signal in the inferior frontal cortex, bilaterally, right frontal cortex, left parathird ventricular region, left cerebral peduncle and in the posterior limb of the left internal capsule as described, most likely represent areas of gliosis/encephalomalacia, the sequelae of previous vascular insult/post-operative changes. (It is difficult to distinguish the frontal lesions from post-operative changes).

3. Altered signal in the suprasellar cistern, more to the left of the midline, may represent haemorrhage/hemostatic material like gel foam, in the given clinical setting.

4. Left optic nerve atrophy with altered signal suggestive of edema/ischemia. Visualized right optic nerve is unremarkable.

5. Mild dilatation of the ventricular system.

No previous investigations were available for comparison.