sb/bv
Date : 00.00.00

Name of the Patient : Abc Xyz Shlmn / F / 17 yrs.
Referred by : Dr. Abc Xyzmpat.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O headaches and vomiting since 25 days.
H/O neck pain with fever. Patient is on AKT.

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.

After administration of contrast the following parameters were used :

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

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is seen a fairly large, approximately 3.5 x 2.2 x 3.5 cms sized conglomeration of multiple rim-enhancing lesions in the cerebellar vermis extending slightly to the right of the midline.
This lesion appears iso to slightly hypointense to normal white matter on the T1 Weighted images and is relatively more hypointense on the proton and T2 Weighted images. There is perilesional edema with mild compression of the fourth ventricle.
Resultant mild dilatation of both the lateral ventricles is noted. The third ventricle is unremarkable.


The basal cisternal spaces are unremarkable. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.

After administration of contrast, enhancement of the tentorial leaflets at the site of contact with the above described lesions is noted bilaterally.

IMPRESSION :

A conglomeration of multiple rim enhancing lesions in the cerebellar vermis as described follow the signal characteristics of multiple tuberculomas. Enhancement of the adjacent tentorial leaflets is also noted. Mild dilatation of both the lateral ventricles is also noted.

As compared to the previous CT Scan dated 00.00.00, there is slight reduction in the size of the ventricles.