ke/bv/rg/nl
Date : 00.00.00

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

CLINICAL PROFILE :

C/O left hemiparesis since 1 year.

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 :

There is a hypointense area in the left lentiform nucleus extending into the left corona radiata on the T1 Weighted images. This is seen to turn hyperintense on the proton and T2 Weighted images. Perilesional hyperintensity is noted on the proton, T2 Weighted and FLAIR images which would represent gliosis. There is dilatation of the body of the left lateral ventricle and this lesion would represent an area of cystic encephalomalacia.

Lacunar infarcts (hypointense on the T1 Weighted images and hyperintense on the proton and T2 Weighted images) are noted in the midbrain on the right side, the right lentiform nucleus, right corona radiata and right centrum semiovale.

Hyperintense areas are seen in the frontal and periatrial deep white matter on the proton, T2 Weighted and FLAIR images. These are isointense to the white matter on the FLAIR images and are suggestive of areas of ischemia/infarction. Similar areas are also noted in the right thalamus.
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There is slight fullness of both the lateral ventricles with ex-vacuo dilatation of the body of the left lateral ventricle. The third and the fourth ventricles are normal. There is slight prominence of the cerebral cortical sulci and cerebellar folia. The basal cisternal spaces are unremarkable. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.

The cervical spine was screened with 4 mm thick T2 Weighted sagittal images which show small posterior disc herniations at the C4-C5 and C5-C6 levels with posterior peridiscal osteophytes.

IMPRESSION :

The MRI features are suggestive of :

1. An area of cystic encephalomalcia in the left lentiform nucleus extending into the left corona radiata.

2. Lacunar infarcts in the midbrain on the right side, right lentiform nucleus, right corona radiata and right centrum semiovale.

3. Altered signal in the frontal and periatrial deep white matter and in the right thalamus would represent areas of ischemia/infarction.