sb/ke
Date : 00.00.00

Name of the Patient : Abc Xyzand Sanlmn / M / 70 yrs.
Referred by : Dr. Abc Xyzmpat.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O right sided hemiparesis since 00.00.00.

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 an ill-defined, hyperintense signal on the proton, T2 Weighted and FLAIR images in the left fronto-temporo-parietal cortex and subcortical white matter, left lentiform nucleus and head of the left caudate nucleus. This lesion appears hypointense on the T1 Weighted images and represents a recent ischemic lesion. There is resultant effacement of the cerebral cortical sulci in the left fronto-temporo-parietal region, indentation and compression of the left lateral and third ventricle and mild bulge of the midline to the right.

There is an ill-defined, hypointense lesion on the T1 Weighted images in the right occipital lobe. Part of this lesion follows CSF signal on all the pulse sequences. Perilesional white matter hyperintense signal is noted in the proton, T2 Weighted and FLAIR images. Resultant mild dilatation of the atrium and occipital horn of the right lateral ventricle is noted.

There is an ill-defined, hyperintense signal on the proton, T2 Weighted and FLAIR images in the periventricular white matter around the frontal horn of the right lateral ventricle. This lesion appears hypointense on the T1 Weighted images.

There is mild dilatation of the right lateral ventricle. The fourth ventricle is normal.

The basal cisternal spaces are unremarkable.
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The petrous and cavernous segments of the left internal carotid artery shows an intraluminal hyperintense signal on the T1 Weighted and T2 Weighted images (loss of normal flow void signal). The left vertebral artery is probably hypoplastic.

There is no obvious haemorrhage on this study.

IMPRESSION :

1. Altered signal in the left fronto-temporo-parietal region as described most likely represents a recent ischemic insult.

2. Altered signal in the right occipital region represents an area of cystic encephalomalacia with perilesional gliosis, ? the sequelae of previous vascular insult.

3. Altered signal in the periventricular white matter around the right frontal horn, most likely represents an ischemic lesion.

4. Loss of normal flow void signal in the petrous and cavernous segments of the left internal carotid artery may suggest thrombus/slow flow.

Suggest MRA study for further evaluation.