sb/hs/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyza Milmn / F / 40 yrs.
Referred by : Dr. Abc Xyzidhungat.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O fever with vomiting since 1 month.
C/O gait ataxia since 20 days.
Known C/O TBM. On AKT since April 0000.

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 T2 Weighted and 5 mm thick FLAIR coronal images.

OBSERVATION :

There is seen an intermediate signal intensity lesion on the T1 Weighted images in the interpeduncular cistern, prepontine cistern and in the right paramedullary cistern extending into the suprasellar cistern. This lesion appears iso to slightly hypointense to CSF on the proton, T2 Weighted and FLAIR images and most likely represent basal exudates.

There are ill-defined, hyperintense areas on the proton, T2 Weighted and FLAIR images in the pons, left inferior frontal region, left fronto-temporal region, in the right frontal region and in the left frontal periventricular white matter. These lesions appear iso to hypointense to normal white matter on the T1 Weighted images. There is an ill-defined, hyperintense signal on the proton, T2 Weighted and FLAIR images in the left temporal lobe which is hypointense on the T1 Weighted images. A suspicious, 1.5 cm diameter sized focal lesion is noted within this area of altered signal (scan 102.8).





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

IMPRESSION :

1. Altered signal intensity lesion in the interpeduncular cistern, prepontine cistern and in the right paramedullary cistern extending into the suprasellar cistern most likely represent basal exudates.

2. Areas of altered signal intensity in the pons, left inferior frontal region, left fronto-temporal region, in the right frontal region and in the left frontal periventricular white matter most likely represent ischemic changes. (It is difficult to exclude granulomas on the unenhanced scan).

3. A suspicious 1.5 cms diameter sized focal lesion in the left temporal lobe, with perilesional hyperintense signal on the T2 Weighted images may represent a granuloma with perilesional edema.

A contrast enhanced scan is essential.