sb/bv
Date : 00.00.00

Name of the Patient : Abc Xyz Blmn / F / 74 yrs.
Referred by : Dr. Abc Xyzah / Dr. Abc Xyzdar.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

Known C/O subarachnoid haemorrhage with a left sided PCOA aneurysm.

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.

OBSERVATION :

There is evidence of a left fronto-temporal craniectomy with post-operative changes in the soft tissues in the left fronto-temporal region.

There is still seen, a hyperintense signal on the FLAIR images in the sulcal spaces in the fronto-temporo-parietal regions bilaterally. This signal appears predominantly isointense to CSF but appears hyperintense to normal CSF in the left Sylvian cistern, left MCA cistern and in the right high parietal region.

Fluid levels are noted in the occipital horns bilaterally.

There is mild dilatation of both the lateral, third and the fourth ventricles. A hypointense signal more pronounced on the proton density images is noted in the posterior third ventricle, aqueduct and the proximal fourth ventricle suggestive of turbulent flow. Periventricular white matter hyperintense signal on proton, T2 Weighted and FLAIR images is noted bilaterally. There is no shift of the midline structures.
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Both eyes are aphakic.

Inflammatory changes are noted in the left maxillary antrum.

IMPRESSION :

1. Post-operative status.

2. Altered signal in the sulcal spaces in the fronto-temporo-parietal regions bilaterally would represent subarachnoid haemorrhage.

3. Mild communicating hydrocephalus.

4. Fluid levels in the occipital horns bilaterally may represent intraventricular haemorrhage.

As compared to the previous MRI (scan no.00006) dated 00.00.00, there is slight increase in the size of the ventricles on the present study. Increase in the periventricular white matter hyperintense signal may suggest periventricular CSF ooze. Intraventricular fluid levels on the present scan suggests intraventricular haemorrhage. A rebleed is a likely possibility.