sb/ke/nl/rg.
Date : 00.00.00

Name of the Patient : Abc XyzDlmn / F / 78 yrs.
Referred by : Dr. Abc Xyzndu.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O right thalamic bleed with intraventricular extension with early hydrocephalus.
Known hypertensive.
For follow-up.

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 and Fast Scan (T2 *) coronal images.

OBSERVATION :

There is still seen a space occupying lesion measuring approximately 3.3 x 3.3 x 2.9 cms and having its epicentre in the right thalamus and extending into the right corona radiata. This lesion is hyperintense to normal whiter matter, peripherally, on the T1 Weighted images and turns more hyperintense on the proton, T2 Weighted and FLAIR images. The centre of the lesion is isointense to normal white matter on the T1 Weighted images and appears hyperintense on the T2 Weighted and FLAIR images. There is perilesional edema with compression of right lateral and third ventricles with mild shift of the midline to the left.

Evidence of subacute haemorrhage is also noted in the occipital horns of the lateral ventricles. Subacute blood is also noted in the midbrain on the right. There is mild dilatation of both the lateral, third and the fourth ventricles with periventricular hyperintensities on the proton, T2 Weighted and FLAIR images.




Areas of hyperintensity on the proton and T2 Weighted images are seen within the white matter in the fronto-parietal lobes bilaterally. These are iso to hypointense to normal white matter on the T1 Weighted images and are most likely ischemic in etiology.

The basal cisternal spaces are prominent. No obvious vascular anomaly is identified on this study.

IMPRESSION :

The MRI features are suggestive of a late subacute bleed measuring approximately 3.3 x 3.3 x 2.9 cms and having its epicentre in the right thalamus and extending into the right corona radiata and dissecting into the ventricular system as described. There is mild communicating hydrocephalus.

As compared to the previous MRI (study no:00002) dated 00.00.00, the haemorrhage is now in the late subacute stage. There is no significant change in the size of the lesion. Mild communicating
hydrocephalus is also noted.