Date : 00.00.00

Name of the Patient : Abc Xyzlla Llmn / F / 63 yrs.
Referred by : Dr. Abc Xyzauvan.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O left eye ptosis 2 months with painful left 3rd nerve palsy.
Known diabetic (controlled) & 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.

3 mm thick T1 Weighted and STIR coronal images.

After administration of contrast the following parameters were used :

5 mm thick T1 Weighted axial images with magnetization transfer,

5 mm thick T1 Weighted sagittal images.

3 mm thick T1 Weighted coronal images with fat saturation.

OBSERVATION :

There are ill-defined, hyperintense areas on the proton and T2 Weighted images in the posterior parietal periventricular white matter bilaterally and in bilateral centrum semiovale. These lesions appear nearly isointense to normal white matter on the T1 Weighted images.

Both the lateral, third and the fourth ventricles are normal. There is slight prominence of the cerebral cortical sulci and basal cisternal spaces bilaterally. There is no shift of the midline structures. The vertebro-basilar system is ectatic with indentation on the brainstem on the left.


The pituitary gland, suprasellar cistern, cavernous sinuses on either side, visualized orbits and optic nerves on either side are unremarkable. No focal mass lesion is identified in the cavernous sinuses or the visualized orbits. The left eye is aphakic. Mucosal thickening is noted in the right maxillary antrum.

After administration of contrast, there is no focal area of abnormal enhancement in the brain parenchyma, the meninges, the cavernous sinuses or the orbits on either side.

IMPRESSION :

Altered signal in the posterior parietal periventricular white matter bilaterally and in bilateral centrum semiovale most likely represent ischemic changes.

No abnormality is detected within the cavernous sinuses, visualized orbits and optic nerves on either side.

The vertebro-basilar system is ectatic, indenting the brainstem on the left.