ke/bv/nl/nl
Date : 00.00.00

Name of the Patient : Abc XyzS. Slmn / F / 25 yrs.
Referred by : Dr. Abc Xyzzare.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O left sided hemiparesis since 2 days with 1 episode of vomiting and dysarthria and drooping of the right eye since 1 day.
H/O similar complaints 4 years back from which patient recovered.

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.

OBSERVATION :

There are hypointense areas on the T1 Weighted images within the right cerebellar hemisphere involving the superior and inferior vermis, right middle cerebellar peduncle, the midbrain on the right side and the right thalamus. These are seen to turn hyperintense on the proton, T2 Weighted and FLAIR images and represent recent infarcts.

An ill-defined hypointense area is seen on the T1 Weighted images in the right temporo-occipital region which is seen to follow CSF intensity characteristics. Hyperintense areas at the periphery of this lesion on the proton, T2 Weighted and FLAIR images which are isointense to the white matter on the T1 Weighted images and represent areas of gliosis. This lesion would represent an area of cystic encephalomalacia. Similar smaller lesion is noted in the left cerebellar hemisphere and left occipital lobe with volume loss and prominence of the cerebellar folia and sulcal spaces respectively.




A lacunar infarct is noted in the pons on the right side.

There is mild fullness of both the lateral and fourth ventricles. The third ventricle is normal. The basal cisternal spaces are unremarkable. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.

IMPRESSION :

1. Recent infarcts within the right cerebellar hemisphere involving the superior and inferior vermis, right middle cerebellar peduncle, the midbrain on the right side and the right thalamus in the distribution of the posterior circulation.

2. An area of cystic encephalomalacia in both temporo-occipital regions and in the left cerebellar hemisphere.

3. A lacunar infarct in the pons on the right side.