ke/hs/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzn lmn / M / 55 yrs.
Referred by : Dr. Abc Xyzisheri.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O sudden onset of right sided hemiparesis on 00.00.00 with slurred speech.
H/O similar complaints 2 years back and 5 months back.
Known hypertensive.

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.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There are hyperintense areas in the left corona radiata on the proton, T2 Weighted and FLAIR images. These are hypointense on the T1 Weighted images and may represent a fresh area of ischemia/infarction.

There is an ill-defined hypointense area in the right parafalcine occipital lobe which is seen to follow CSF signal intensity characteristics on all the pulse sequences. Hyperintense signal on the proton, T2 Weighted and FLAIR images at the periphery of this lesion would represent areas of gliosis and the lesion would represent an area of cystic encephalomalacia.

Lacunar infarcts (iso to hyperintense to CSF on all the pulse sequences) are seen in the left lentiform nucleus, ventro-medial aspect of the right thalamus, splenium of the corpus callosum on the right side and bilateral corona radiata.


An area of hypointensity on the T1 Weighted images which turns hyperintense on the T2 Weighted images is seen in the left external capsule and may represent gliotic changes.

A hypointense signal on the T2 Weighted images adjacent to this would represent hemosiderin/paramagnetic substances (? previous bleed).

There is fullness of both the lateral and third ventricles. The fourth ventricle is normal.

There is mild prominence of the cerebral cortical sulci and cerebellar folia bilaterally. 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. Altered signal in the left corona radiata would represent a fresh area of ischemia/infarction.

2. An area of cystic encephalomalacia in the right parafalcine occipital lobe.

3. Lacunar infarcts in the left lentiform nucleus, ventro-medial aspect of the right thalamus, splenium of the corpus callosum on the right side and bilateral corona radiata.

4. Area of altered signal within the left external capsule would represent gliotic changes with hemosiderin/ paramagnetic substances.

5. Age related cerebral and cerebellar atrophy.