sb/bv
Date : 00.00.00

Name of the Patient : Abc XyzGlmn / M / 33 yrs.
Referred by : Dr. Abc Xyzagwati.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O 10-12 episodes of seizures with altered sensorium since 00.00.00.
H/O jaundice since 1 month.
Known alcoholic.

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, T2 Weighted and Fast Scan (T2 *) coronal images.

OBSERVATION :

There is an ill-defined, hyperintense signal on the proton, T2 Weighted and Fast Scan (T2 *) images in the subcortical white matter in the left high parietal regions. This lesion appears hypointense on the T1 Weighted images.

There is an ill-defined, hyperintense signal on the T1 Weighted images in the globus pallidus bilaterally extending into the subthalamic region. This lesion appears isointense to normal grey matter on the proton, T2 Weighted and Fast Scan (T2 *) images.

Hyperintense signal on the T2 Weighted and FLAIR images is also noted in the posterior parietal deep white matter bilaterally.






Prominent perivascular spaces are noted in the cerebral hemisphere.

Both the lateral, third and the fourth ventricles are normal. The basal cisternal spaces are unremarkable. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.

Inflammatory changes are noted in the maxillary sinuses bilaterally, posterior ethmoidal air cells and right mastoid air cells.

IMPRESSION :

1. Altered signal in the subcortical white matter in the left high parietal parafalcine region and in the posterior parietal deep white matter bilaterally most likely represent ischemic changes.

2. Altered signal in the globus pallidus bilaterally extending into the subthalamic region, may represent paramagnetic substance deposition. Such changes may be seen in hepato-cerebral syndrome.