hs/ke
Date : 00.00.00

Name of the Patient : Abc Xyzuddin Marlmn / M / 30 yrs.
Referred by : Dr. Abc Xyzrani.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O Patient was operated upon for left cerebellar granulomas. AT present the patient has gait imbalance.
For follow up.

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 coronal images with magnetization transfer.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is evidence of a craniotomy in the left occipital region with resultant post-operative changes.

There are areas of hypointensity on the T1 Weighted images which turn hyperintense on the proton, T2 Weighted and FLAIR images within the left cerebellar hemisphere. Also seen are a few areas which are isointense to CSF within this lesion. This lesion would represent areas of encephalomalacia. Few areas with similar signal are seen within the right cerebellar hemisphere and pons and middle cerebellar peduncle on the left side. There is exvacuo dilatation of the fourth ventricle.
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Also seen is thickening of the tentorial leaflets and falx (especially posteriorly). After contrast administration there is enhancement of the tentorial leaflets and meninges overlying both cerebral hemispheres. The intracranial lesions however do not enhance.

A focus which is near isointense to CSF is seen within the thalamus on the left side and this may represent a lacune.

There is evidence of a large lesion which is mildly hyperintense to CSF on all the pulse sequences in the right fronto-temporal region. There is mild compression upon the right lateral ventricle with minimal shift to the contralateral side. This may represent an arachnoid cyst.

Thre is mild fullness of the left lateral ventricle.

No obvious vascular anomaly is identified on this study.

IMPRESSION :

The MRI features are suggestive of :

1. Post-operative status.

2. Areas of encephalomalacia in the cerebellar hemispheres (left more than right).

3. An arachnoid cyst in the right fronto-temporal region.

4. Thickening of the tentorial leaflets and meninges overlying both cerebral hemispheres bilaterally.