sb/bv/rg.
Date : 00.00.00

Name of the Patient : Abc XyzDhumlmn / M / 13 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

Known C/O TBM detected 2 years back. Completed AKT.
C/O seizures since 1 year. On anti-epileptics.

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 periatrial white matter. This lesion appears hypointense to normal white matter on the T1 Weighted images. Resultant mild focal dilatation of the atrium of the left lateral ventricle is noted.

A lacunar infarct is noted in the left thalamus.

There is a small subcentimeter, hypointense lesion on the T2 Weighted images in the left occipital parafalcine cortex and in the left posterior parietal cortex (scans 102.11 & 102.14). These lesion are not well-identified on the T1 Weighted images. There is no perilesional edema. Another circumscribed hypointense area is seen in the right occipital cortex on the Fast Scan (T2 *) images (Image No. 5).

The right lateral, third and the fourth ventricles are normal. The basal cisternal spaces are unremarkable. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study. The left temporal horn appears slightly larger than the right and may be a normal variant.
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IMPRESSION :

1. Altered signal in the left periatrial white matter may be ischemic in etiology (in the known C/O TBM).

2. A lacunar infarct in the left thalamus (may be the result of vasculitis).

3. Focal subcentimeter lesions in both occipital parafalcine cortex and in the left posterior parietal cortex most likely represent calcified granulomas.