sb/hs
Date : 00.00.00

Name of the Patient : Abc Xyzid Almn / F / 71 yrs.
Referred by : Dr. Abc XyzShah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O headaches with blurred vision with momentary blackouts on the left side since 2-3 months.
H/O being operated for left Ca breast 18 years back.
Known hypertensive. On Rx.

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.

3 mm thick STIR coronal images.

OBSERVATION :

There are ill-defined, hyperintense areas on the proton, T2 Weighted and FLAIR images in the subcortical/deep white matter in the fronto-parietal regions bilaterally, periventricular white matter bilaterally, in the pons and in the head of left caudate nucleus. These lesions appear iso to hypointense to normal white matter on the T1 Weighted images.

There is mild fullness of both the lateral and the third ventricles. The fourth ventricle is normal. There is slight prominence of the cerebral cortical sulci and basal cisternal spaces. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.





There is an expansile, hypointense signal intensity lesion on the T1 Weighted images in the frontal bone bilaterally in the midline, left parietal bone (probably) and along the greater wing of the left sphenoid bone with slight indentation of the left optic nerve. This lesion appears relatively hyperintense on the proton, T2 Weighted and STIR images. Resultant cortical thinning and probable erosion of the cortex is noted.

IMPRESSION :

1. Altered signal in the subcortical/deep white matter in the fronto-parietal regions bilaterally, periventricular white matter bilaterally, in the pons and in the head of the left caudate nucleus most likely represent ischemic changes.

2. Altered signal in the frontal bones bilaterally in the midline, left parietal bone (probably) and along the greater wing of the left sphenoid bone as described is not specific for a single etiology. In the given clinical setting of past h/o Ca breast, metastasis is a likely possibility (?? fibrous dysplasia).