ke/sb
Date : 00.00.00

Name of the Patient : Abc XyzKhlmn / M / 60 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O sudden onset of breathlessness on 00.00.00 with speech difficulty since then.
C/O bladder involvement with weakness of the RUE and RLE.
Known hypertensive.

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 thickening of the gyri in the left temporo-parietal region. There are hypointense areas in the left temporo-parietal cortex and subcortical white matter on the T1 Weighted images which are seen to turn hyperintense on the proton, T2 Weighted, FLAIR and Fast Scan (T2 *) coronal images. Involvement of the insular cortex, external capsule and the left lentiform nucleus is also noted. Few hyperintense areas are seen along the cortex and a well-defined hyperintense area is seen within the left lentiform nucleus on the T1 Weighted images which remain so on the proton, T2 Weighted and FLAIR images but show a subtle hypointense signal on the Fast Scan (T2 *) images, these would represent altered blood and the lesion would represent a haemorrhagic infarct. There is mild mass effect with effacement of the adjacent sulci and indentation upon the body of the left lateral ventricle.

A lacunar infarct (hyperintense to CSF on all the pulse sequences) is noted in the body of the caudate nucleus on the right side.

Ischemic foci are also noted in the right high parietal cortex and in the posterior parietal white matter bilaterally.

Intermediate signal intensity is seen in the cavernous as well as the petrous portion of the internal carotid artery on the right side on the T1 Weighted images which is seen to turn hyperintense on the proton and T2 Weighted images and would represent thrombus.
..2/..






- 2 -


The right lateral, third and the fourth ventricles are normal. The basal cisternal spaces are unremarkable. There is slight prominence of the cerebral cortical sulci in the fronto-parietal regions and in the cerebellar folia bilaterally.

Inflammatory changes are noted in the sphenoid sinus on the left side.

IMPRESSION :

1. A haemorrhagic infarct in the left temporo-parietal region.

2. A lacunar infarct in the body of the caudate nucleus on the right side.

3. Thrombus in the cavernous as well as the petrous portion of the internal carotid artery on the right side.

4. Ischemic foci in the right high parietal cortex and in the posterior parietal white matter bilaterally.