sb.
Date : 00.00.00

Name of the Patient : Abc Xyzd Bhanlmn / M / 45 yrs.
Referred by : Dr. Abc Xyzah.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O seizures since 00.00.00.
H/O fever +.

EXAMINATION :

The brain was screened with 5 mm thick T2 Weighted axial images, 5 mm thick FLAIR coronal images and 5 mm thick T1 Weighted sagittal images.

Intracranial and neck MRA were performed with 3D TOF and 2D TOF sequences, respectively.

OBSERVATION :

There is an ill-defined, hyperintense area along the cortex in the left high parietal, parafalcine region, the medial aspect of the left temporal lobe and the right frontal lobe on the T2 Weighted and FLAIR images which is iso to hypointense to normal white matter on the T1 Weighted images.

Both the lateral, third and the fourth ventricles are normal. The basal cisternal spaces are unremarkable. There is no shift of the midline structures.

Incidental note is made of right maxillary polyp.









INTRACRANIAL MRA :

The petrous, cavernous and supraclinoid segments of the internal carotid arteries bilaterally show normal signal and calibre. The visualized anterior cerebral, middle cerebral, basilar, vertebral and posterior cerebral arteries also show normal signal, calibre and wall margins. No obvious aneurysm or vascular malformation is identified.

NECK MRA :

The common carotid arteries and their extracranial branches appear normal bilaterally. There are no vessel wall irregularities or stenosis of the vessels noted.

IMPRESSION :

1. Altered signal along the cortex in the left high parietal, parafalcine region, the medial aspect of the left temporal lobe and right frontal cortex, as described is not specific for a single etiology.

The differential diagnosis would include,

1. Multicentric glial cell tumor.

2. Sequelae of previous encephalitis.

3. Post-ictal changes.

4. Less likely, vascular lesions or granulomas.

2. No significant abnormality is detected on the intracranial and neck MRA on this study.

A contrast enhanced scan is essential.