sb/hs/rg.
Date : 00.00.00

Name of the Patient : Abc Xyziclmn / M / 42 yrs.
Referred by : Dr. Abc Xyzah / Dr. Abc Xyzadhan.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O seizures since 10-12 years. On anti-epileptics.
Now C/O memory impairment since 1 month.

EXAMINATION :

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

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

3 mm thick T2 Weighted coronal images.

OBSERVATION :

There is a CSF signal intensity lesion on all the pulse sequences in the left occipital lobe. This lesion represents an area of cystic encephalomalacia, most likely the sequelae of a previous vascular insult. A subtle hyperintense signal on the T1 Weighted images at the periphery of this lesion, which appears hypointense on the T2 Weighted images may represent haemoglobin breakdown products/paramagnetic substance deposition. Perilesional white matter hyperintense signal on the proton, T2 Weighted and FLAIR images may represent gliotic changes. Resultant focal dilatation of the occipital horn, atrium and posterior body of the left lateral ventricle is noted.

Lacunar infarcts (isointense to hyperintense to CSF) are noted in the pons on the left, periatrial white matter on the right, thalamus and lentiform nucleus bilaterally and in the corona radiata and centrum semiovale bilaterally.

Ill-defined hyperintense signal on the proton, T2 Weighted and FLAIR images in the posterior parietal periventricular white matter on the right and in the left frontal periventricular white matter may also represent ischemic changes.

The hippocampal complex on either side is unremarkable.
..2/.





A hyperintense speck (se/im 104.18) on the T1 Weighted images is seen within the left frontal lobe (? petechial haemorrhage/? calcium).

There is mild fullness of both the lateral and the third ventricles. The fourth 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. An area of cystic encephalomalacia in the left occipital lobe, most likely the sequelae of a previous vascular insult.

2. Lacunar infarcts in the pons on the left, periatrial white matter on the right, thalamus and lentiform nucleus bilaterally and in the corona radiata and centrum semiovale bilaterally.

3. Altered signal in the right posterior parietal and left frontal periventricular white matter may represent ischemic changes.