ke/hs/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzi Kalmn / F / 70 yrs.
Referred by : Dr. Abc Xyzwant.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O left 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.

Patient refused contrast administration.

OBSERVATION :

There is an ill-defined, hypointense area on the T1 Weighted images in the left lentiform nucleus, extending into the left corona radiata and left centrum semiovale. This is seen to turn hyperintense on the proton, T2 Weighted, FLAIR and Fast Scan (T2 *) images. Similar areas are also noted involving the head of the caudate nucleus on the left side and the right cerebellar hemisphere.

The cavernous portion of the internal carotid artery on the left side shows an intermediate signal on the T1 Weighted images which is heterogeneously hyperintense on the proton and T2 Weighted images. This would represent thrombus/slow flow.

A hypointense area is noted in the right lentiform nucleus extending into the right corona radiata on the T1 Weighted images and follows CSF signal characteristics on all the pulse sequences and this represents a lacunar infarct.
Scan-00005


There are hyperintense areas in the periatrial white matter on the proton, T2 Weighted and FLAIR images which are iso to hypointense to white matter on the T1 Weighted images suggestive of areas of ischemia/infarction.

A small hypointense area is noted in the right frontal region which is seen to remain hypointense on the T2 Weighted and FLAIR images (se/im 106/9, 105/10). This may represent a calcified granuloma.

Both the lateral, third and the fourth ventricles are normal. The basal cisternal spaces are unremarkable. There is no shift of the midline structures.

Incidental note is made of left maxillary sinusitis and inflammatory changes in the ethmoidal air cells on the left side.

IMPRESSION :

1. Altered signal in the left lentiform nucleus, extending into the left corona radiata and left centrum semiovale and smaller areas of altered signal in the head of the caudate nucleus on the left side and the right cerebellar hemisphere are suggestive of areas of ischemia/infarction.

2. Slow flow/thrombus in the cavernous portion of the internal carotid artery on the left side

3. A lacunar infarct in the right lentiform nucleus extending into the right corona radiata.

4. Areas of altered signal in the periatrial white matter may represent areas of ischemia/infarction.

5. Altered signal in the right frontal region may represent a calcified granuloma.

A contrast enhanced scan would be worthwhile.