Date : 00.00.00

Name of the Patient : Abc Xyz Salmn / M / 26 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

Known C/O pontine astrocytoma. Received 30 cycles of Radiotherapy.
Headaches, diplopia and ataxia still persist.

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 coronal images.

5 mm thick T1 Weighted and T2 Weighted sagittal images.

OBSERVATION :

There is an ill-defined, hypointense area in the pons on the T1 Weighted images which is seen to turn hyperintense on the proton, T2 Weighted and FLAIR images. Superiorly this lesion is seen to extend upto the tectum and the lower mid-brain, more on the left side. Inferiorly, the medulla is also involved. There is extension into the middle cerebellar peduncles, bilaterally, left more than right. Slight involvement of the left cerebellar hemisphere is also seen. There is mass effect with compression of the fourth ventricle as well as the foramen of Luschka and Magendie.

There is resultant mild dilatation of both the lateral and the third ventricles with periventricular CSF ooze.

There is beaking of the cerebellar tonsils with herniation and the tip is seen to lie below the foramen magnum level.

The basal cisternal spaces are unremarkable. No obvious vascular anomaly is identified on this study.
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IMPRESSION :

The MRI features are suggestive of an ill-defined mass lesion in the pons extending superiorly into the tectum and the lower mid-brain on the left side and inferiorly, into the medulla with mass effect as described. This most likely represent a neoplastic process like an astrocytoma. There is mild obstructive hydrocephalus.

Previous investigations were not available for comparison.