Date : 00.00.00

Name of the Patient : Abc XyzDlmn / M / 79 yrs.
Referred by : Dr. Abc Xyzdar.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O headaches with heaviness, one episode of seizures and vertigo.

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.

After administration of contrast the following parameters were used :

5 mm thick T1 Weighted axial and 4 mm thick T1 coronal images with magnetization transfer.

4 and 5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is a large well-defined mass lesion in the left cerebellar hemisphere which measures approximately 3.0 x 4.0 x 2.5 cms. This lesion has a predominant cystic portion which is slightly hyperintense to the CSF on all the pulse sequences. An intermediate signal intensity lesion is seen along the floor and the anterior portion of the lesion on the T1 Weighted images which is slightly hypointense on the proton, T2 Weighted and FLAIR image. A fluid level is also seen within this lesion. There is compression upon the left postero-lateral aspect of the fourth ventricle and the aqueduct with slight shift of the midline structures to the right. There is slight effacement of the perimesencephalic cistern on the left side. On administration of contrast, there is faint enhancement of the lesion at the periphery which is slightly irregular in the anterior and posterior aspect. There is no other area of abnormal enhancement within the brain parenchyma.
..2/.








Small lacunar infarcts (isointense to CSF on all the pulse sequences) are noted in the left temporal region, bilateral thalami and corona radiata.

Small bright foci are noted on the proton, T2 Weighted and FLAIR images in the fronto-parietal region. These are isointense to white matter on the T1 Weighted images and are probably ischemic in etiology.

There is fullness of both the lateral ventricles. The third ventricle is normal. No obvious vascular anomaly is identified on this study.

After contrast administration there is no area of abnormal enhancement in the brain parenchyma or along the meninges.

IMPRESSION :

The MRI features are suggestive of :

1. A mass lesion in the left cerebellar hemisphere measuring approximately 3.0 x 4.0 x 2.5 cms. The differential diagnosis would include :

a. A cystic glioma.

b. Hemangioblastoma.

2. Altered signal in the fronto-parietal region is probably ischemic in etiology.