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Sunday, 27 December 2015 16:48

14571

ke/hs/nl/nl
/573 Date : 00.00.00

Name of the Patient : Abc Xyz Chlmn / M / 52 yrs.
Referred by : Dr. Abc XyzMalgaonkar.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O right sided hemiparesis with slurred speech since 15 days.
Known hypertensive.

EXAMINATION :

The brain was screened with 5 mm thick T2 Weighted axial images.

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

OBSERVATION :

There is a hypointense area on the T1 Weighted images in the left frontal deep white matter. This is seen to turn hyperintense on the T2 Weighted images and represents an area of ischemia/ infarction. Similar area is also noted in the left lentiform nucleus posteriorly and in the left paraatrial deep matter and these are also most likely ischemic in etiology.

A lacunar infarct is noted in the left cerebellar hemisphere.

There is prominence of the cerebellar folia and cerebral cortical sulci bilaterally.

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

Note is made of a retrocerebellar arachnoid pouch.

INTRACRANIAL MRA :

The mid portion of the left middle cerebral artery for a distance of approximately 4.0 mms. is not visualized. There appears to be slight paucity of vessels in the left Sylvian area.
..2/.








The petrous, cavernous and supraclinoid segments of the internal carotid arteries bilaterally show normal signal and calibre. The visualized anterior cerebral, right 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 left vertebral artery is seen to arise from the aortic arch.

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. Areas of ischemia/infarction in the left frontal deep white matter, in the left lentiform nucleus posteriorly and in the left paraatrial deep matter.

2. A lacunar infarct in the left cerebellar hemisphere.

3. Non-visualization of the mid portion of the left middle cerebral artery for a distance of approximately 4.0 mms.

Sunday, 27 December 2015 16:48

14570

ke/bv/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyz V. Arslmn / M / 19 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O seizures since 5 years.

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 T2 Weighted coronal images.

OBSERVATION :

There is prominence of the cerebellar folia bilaterally with resultant dilatation of the fourth ventricle. The inferior vermis appears hypoplastic.

There is no focal area of altered signal intensity in the brain parenchyma.

The hippocampal complex on either side is unremarkable.

Both the lateral and third 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.

Incidental note is made of right maxillary sinusitis and a Thornwaldts cyst.

IMPRESSION :

Gross cerebellar atrophy.











Sunday, 27 December 2015 16:48

14569

ke/bv/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzahadur Slmn / M / 50 yrs.
Referred by : Dr. Abc Xyzchale.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O left sided hemiparesis with altered sensorium since 4 days.
H/O left sided hemiparesis in 0000 and 0000 from which patient recovered.
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 and Fast Scan (T2 *) coronal images.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There are hypointense areas on the T1 Weighted images in the ventro-medial thalami bilaterally, subthalamus extending into the upper midbrain on the right side. These are seen to turn hyperintense on the proton, T2 Weighted and FLAIR images and represents a recent infarct (scans 108.9, 10, 103.9 to 12, 102.9 to 12, 106.11).

Similar smaller areas are seen in bilateral corona radiata and centrum semiovale and represent ischemic changes.

Lacunar infarcts are seen in corona radiata with surrounding gliotic changes.







A linear hypointense signal on the T1 Weighted images is noted in the right external capsule which is seen to turn hyperintense on the proton and T2 Weighted images and blooms on the Fast Scan (T2 *) images and represents residual hemosiderin, the result of a previous bleed (scans 104.12, 106.12).

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

IMPRESSION :

1. Recent infarcts in the ventro-medial thalami bilaterally, subthalamus extending into the upper midbrain on the right side.

2. Residual hemosiderin in the right external capsule.

3. Lacunar infarcts in the corona radiata.













Sunday, 27 December 2015 16:48

14568

ke/bv/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyz. Jalmn / M / 42 yrs.
Referred by : Dr. Abc Xyzrekh.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O neckpain radiating to BUE with paresthesias.

EXAMINATION :

M.R.I of the cervical spine was performed using the following parameters :

4 mm thick T1 Weighted and T2 Weighted sagittal images.

5 mm thick T1 Weighted and Fast Scan (T2 *) axial images.

OBSERVATION :

There is loss of water content of the cervical intervertebral discs.A small posterior and right paracentral disc herniation with peridiscal osteophytes is noted at the C4-C5 level with resultant minimal indentation on the cervical spinal cord anteriorly. Left paracentral disc herniations with peridiscal osteophytes are noted at the C5-C6 and C6-C7 levels. Slight left neural foraminal narrowing is noted at the C5-C6 and C6-C7 levels with indentation upon the spinal cord and the left C6 and C7 nerve roots, respectively. A small posterior disc bulge is noted at the C3-C4 level. The cervical vertebral bodies reveal normal signal intensity. The joints of Luschka and the visualized pre and paravertebral soft tissues are unremarkable.



The cervical spinal cord reveals normal signal intensity.The atlanto-axial region and the cervico-medullary junction are unremarkable.
IMPRESSION :1. A small posterior and right paracentral disc herniation with peridiscal osteophytes at the C4-C5 level.2. Left paracentral disc herniations with peridiscal osteophytes at the C5-C6 and C6-C7 levels with left neural foraminal narrowing and indentation upon the left C6 and C7 nerve roots, respectively.
As compared to the previous MRI (study no:0000) dated 00.00.00, there is no significant change noted.



Sunday, 27 December 2015 16:48

14567

ke/bv/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzi Talmn / F / 22 yrs.
Referred by : Dr. Abc Xyzwhale.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the RLE since 1 year.

EXAMINATION :

M.R.I of the lumbo-sacral spine was performed using the following parameters :

5 mm thick T1 Weighted and T2 Weighted sagittal images.

5 mm thick T1 Weighted and T2 Weighted axial images.

5 mm thick Fast Scan (T2 *) coronal images.

OBSERVATION :

There is an ill-defined, hypointense area on the T1 Weighted images within the L3 vertebral body predominantly on the right side. Few hyperintense streaks are noted on the T1 Weighted images within this lesion. Lateral wedging of L3 is also identified on the right side. This lesion is seen to turn heterogeneously hyperintense on the T2 Weighted and Fast Scan (T2 *) images. There is slight bulging of the posterior aspect of the L3 vertebra with indentation upon the thecal sac. The right pedicle is also involved. There is suspicion of a break in the posterior cortex (scans 103.4, 103.5, 102.4, 102.5, 105.3, 105.4, 206.10, 206.11).

Small posterior disc bulges are noted at the L4-L5 and L5-S1 levels.

A limbus vertebra is identified at the D12 level.



The rest of the lumbar vertebral bodies and the intervertebral discs reveal normal signal intensity. The facet joints and the visualized pre and paravertebral soft tissues are unremarkable.

The conus medullaris terminates at the L1 level and the thecal sac terminates at the S2 level.

The antero-posterior dimensions of the lumbar canal at the level of the intervertebral discs are as follows :

15.0 mm at L1-L2
15.0 mm at L2-L3
16.0 mm at L3-L4
13.0 mm at L4-L5
13.0 mm at L5-S1.

IMPRESSION :

Altered signal in the L3 vertebral body and right pedicle as described is most probably due to a hemangioma.

The possibility of a neoplastic or an infective process is unlikely.




Sunday, 27 December 2015 16:48

14566

ke/bv/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzmmed Ibrahim Anlmn / M / 1 yr.
Referred by : Dr. Abc Xyzshi.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O fever since 15 days with 1 episode of convulsion on 00.00.00.

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 no focal area of altered signal intensity in the brain parenchyma. (Hyperintense signal on the proton and T2 Weighted images in the periatrial white matter represents areas of terminal myelination (scans 102.13, 14, 105.1, 2)).

The hippocampus complex is unremarkable on either side. The myelination pattern appears normal for the patients age.

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.

IMPRESSION :

Normal study of the Brain.

A contrast enhanced scan may be useful if cerebritis/meningitis is clinically suspected.












Sunday, 27 December 2015 16:48

14565

ke/bv/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzshkumar Jailmn / M / 5 1/2 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O seizures since the age of 6 months.

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 T2 Weighted coronal images.

OBSERVATION :

There is reduction in the volume of the head of the hippocampus bilaterally extending into the body and tail, (right more than the left). Hyperintense signal is seen on the T2 Weighted images in the hippocampal complex bilaterally (scans 105.5 to 105.10, 106.5 to 106.10).

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.

Incidental note is made of enlarged adenoids and inflammatory changes are seen in the maxillary sinuses and ethmoidal air cells.

IMPRESSION :

The MRI features are suggestive of bilateral mesial temporal sclerosis.













Sunday, 27 December 2015 16:48

14564

ke/bv/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzdin Shlmn / M / 15 yrs.
Referred by : Dr. Abc Xyzawale.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O altered behaviour since 10-15 days.

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.

3 mm thick T2 Weighted coronal images.

OBSERVATION :

There is no focal area of altered signal intensity in the brain parenchyma.

Hyperintense signal seen on the proton density images in the frontal regions bilaterally (scans 103.14, 103.15) probably represents trapped CSF.

The hippocampus complex on either side is unremarkable.

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.

IMPRESSION :

Normal study of the Brain.













Sunday, 27 December 2015 16:48

14563

ke/bv/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyz H. Shlmn / M / 9 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O seizures since the age of 2 months.

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 T2 Weighted coronal images.

OBSERVATION :

There is no focal area of altered signal intensity in the brain parenchyma.

The hippocampus complex is unremarkable on either side.

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.

Incidental note is made of enlarged adenoids.

Inflammatory changes are noted in the maxillary sinuses and ethmoidal air cells bilaterally.

IMPRESSION :

Normal study of the Brain.









Sunday, 27 December 2015 16:48

14562

ke/bv/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyz D. Pandhilmn / M / 41 yrs.
Referred by : Dr. Abc Xyzrges.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

H/O fever with chills on 00.00.00 with giddiness, numbness on the left half of the body, headaches and change in voice since 00.00.00.
C/O right sided hemiparesis in 0000.
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 :

There are hyperintense areas located in the medulla on the right side (scans 103.3, 102.3, 104.3) on the T2 Weighted, FLAIR and proton density images. This area appears isointense on the T1 Weighted images.

There are lacunar infarcts (isointense to CSF on all the pulse sequences) in the pons, bilateral lentiform nuclei and corona radiata. Hyperintense areas on the proton, T2 Weighted and FLAIR images in the corona radiata bilaterally adjacent to the lacunar infarcts would represent areas of gliosis.

There is mild dilatation of the ventricular system. There is prominence of the cerebral cortical sulci and cerebellar folia bilaterally.






The basal cisternal spaces are unremarkable. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.

Incidental note is made of thickening of the mucosa in the maxillary sinuses bilaterally.

IMPRESSION :

1. Right lateral medullary infarct.

2. Lacunar infarcts in the pons, bilateral lentiform nuclei and corona radiata with gliotic changes in the corona radiata bilaterally.

3. Cerebral and cerebellar atrophy.