sb/bv
Date : 00.00.00

Name of the Patient : Abc Xyzr Dlmn / M / 49 yrs.
Referred by : Dr. Abc Xyzrani.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

H/O surgery in 0000 for skull base schwannoma (? Xth nerve schwannoma).
Recent H/O purulent discharge from the left ear.

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 T1 Weighted coronal images.

5 mm thick FLAIR coronal images.

An MR Cisternogram was also obtained in the coronal plane.

OBSERVATION :

There is seen an approximately 2.0 x 1.2 x 2.0 cms sized intermediate signal intensity mass lesion on the T1 Weighted images in the region of the skull base on the left, eroding the clivus on the
left and partially eroding the left petrous tip. This lesion appears significantly hyperintense on the proton, T2 Weighted and FLAIR images. Intermediate signal is noted in the left internal jugular vein at the site of the tumor which may suggest ? thrombosis/? tumor extension.

There is evidence of operative intervention in the left temporo-occipital region.

Volume loss in the left cerebellar hemisphere is noted with an ill-defined, CSF intensity lesion on all the pulse sequences in the left cerebellar hemisphere which may represent gliotic/encephalomalacic changes, the sequelae of previous surgery. Resultant mild dilatation
and pull of the fourth ventricle to the left is noted. The nerve root sleeve in the left internal auditory canal appears slightly baggy.

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

Altered signal in the left mastoid air cells may suggests an inflammatory changes. ...2/..









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IMPRESSION :

1. Post-operative status.

2. An approximately 2.0 x 1.2 x 2.0 cms sized mass lesion in the region of the skull base on the left, eroding the clivus on the left and partially eroding the left petrous tip as described may represent residual/recurrent skull base schwannoma.

3. Volume loss with altered signal in the left cerebellar hemisphere represents
encephalomalacic changes, the sequelae of previous surgery. Resultant mild
dilatation of fourth ventricle is noted.

No previous scans were available for comparison.

A repeat scan, if necessary with contrast would be useful.