ke/bv
Date : 00.00.00

Name of the Patient : Abc Xyzlmn / F / 78 yrs.
Referred by : Dr. Abc Xyzmpat / Dr. Abc Xyzdar.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O chronic subdural hematoma which has been drained twice in past 8 days.
Known hypertensive.

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 :

Burrholes are noted in the high parietal region bilaterally one on the left side and two on the right side.

There is still seen a small residual subdural collection overlying the right cerebral convexity with a maximum width of about 1.2 cms. This lesion is hypointense to gray matter on the T1 Weighted images but appears hyperintense on the proton, T2 Weighted and FLAIR images. A sliver of hyperintense signal is seen over the temporo-occipital region on all the pulse sequences which may suggest xantho chronic fluid. A loculated pocket is noted in the right parietal region.

There is seen a much smaller, similar (as described above) signal intensity, subdural collection overlying the left cerebral hemisphere with a maximum width of about 0.8 cms in the left high parietal region.

There is an ill-defined, hyperintense signal on the proton, T2 Weighted and FLAIR images in the head of right caudate nucleus and right lentiform nucleus. This lesion appears slightly hypointense to normal white matter on the T1 Weighted images.
..2/.







There is mild dilatation of the left lateral ventricle. There is an ill-defined hyperintense signal on proton, T2 Weighted and FLAIR images in the periventricular white matter around the left lateral ventricle. Similar signal is also noted in the head of left caudate nucleus. This signal appears hypointense to normal white matter on the T1 Weighted images and probably represents encephalomalacic changes.

There is prominence of the cerebellar folia bilaterally with mild fullness of the fourth ventricle.

No obvious vascular anomaly is identified on this study.

IMPRESSION :

1. Post-operative status.

2. A residual subdural collection overlying the right cerebral convexity with a maximum width of about 1.2 cms.

3. A smaller subdural collection overlying the left cerebral hemisphere.

4. Altered signal in the head of the caudate nuclei bilaterally and right lentiform nucleus may represent ischemic changes.

5. Mild dilatation of the left lateral ventricle with periventricular white matter hyperintense signal on proton, T2 Weighted and FLAIR images may represent periventricular encephalomalacic changes.

As compared to the previous MRI (study no:00007) dated 00.00.00, there is reduction in the size of the subdural collections bilaterally.