ke/bv/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzn Jalmn / M / 41 yrs.
Referred by : Dr. Abc Xyzrges.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O altered sensorium with fever since 8 days.

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.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is a large ill-defined area in the left frontal lobe and the right frontal parafalcine region which is hypointense to gray matter on the T1 Weighted images. This is seen to turn heterogeneously hyperintense on the proton, T2 Weighted and FLAIR images. The rostrum, genu and the anterior portion of the body of the corpus callosum is also involved by the pathology. Few hyperintense areas are seen within this lesion on the T1 Weighted images which are hyperintense on the proton, T2 Weighted and FLAIR images and may represent extracellular methaemoglobin/ paramagnetic substances. There is mass effect with effacement of the adjacent sulci with compression upon the frontal horn of both the lateral ventricles. There is slight shift of the anterior falx to the left side.

There are small well-circumscribed areas in the pons anteriorly to the right and posteriorly to the left and the right middle cerebellar peduncle adjacent to the fourth ventricle. These are hyperintense on the proton, T2 Weighted and FLAIR images.



There is slight fullness of both the lateral ventricles. The third and the fourth ventricles are normal. The basal cisternal spaces are unremarkable. No obvious vascular anomaly is identified on this study.

IMPRESSION :

The MRI features are suggestive of :

1. Altered signal in the left frontal lobe and the right parafalcine frontal region and rostrum, genu and the anterior portion of the body of the corpus callosum.

2. Altered signal in the pons anteriorly to the right and posteriorly to the left and the right middle cerebellar peduncle adjacent to the fourth ventricle.

These are not specific for a single etiology.

These changes may be seen with :

a. Neoplasia.

b. Vascular insults.

c. Demyelinating lesions.

A contrast enhanced scan may be worthwhile.