sb/ke/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzar Tanalmn / M / 35 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O fever with giddiness and gait ataxia since 4 months.
H/O involuntary closure of both eyes with inability to swallow 6 days back. Recovered within 3 days.
C/O occasional diplopia.

EXAMINATION :

M.R.I of the brain was performed using the following parameters :

5 mm thick T1 Weighted, proton and T2 Weighted axial images.

4 mm thick FLAIR coronal images.

FEW IMAGES SHOW PATIENT MOTION.

OBSERVATION :

There are small bright foci on the proton, T2 Weighted and FLAIR images in the midbrain, posteriorly, left thalamus, left insular cortex and in the left frontal deep white matter. These lesions appear isointense to normal white matter on the T1 Weighted images.

There is a very thin, subdural collection over the left cerebral convexity with a maximum width of about 4.0 mms. This lesion is hyperintense on all the pulse sequences. Similar signal intensity lesion is noted in the subdural space in the right fronto-temporo-occipital region.

Both the lateral, third and the fourth ventricles are normal. There is prominence of the cerebral cortical sulci, cerebellar folia and the basal cisternal spaces bilaterally. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.


IMPRESSION :

1. A very small, subdural collection/hematomas over the left cerebral convexity and in the right fronto-temporo-occipital region.

2. Altered signal in the midbrain, posteriorly, left thalamus, left insular cortex and in the left frontal deep white matter is not specific for a single etiology.

These changes may represent :

a. Ischemic lesions.

b. Shearing injuries (in view of the bilateral very small subdural hematomas.

c. The possibility of demyelinating lesions is less likely.

d. Meningitis unlikely.