PATIENT:
CHART
NUMBER:
DATE:
REFERRING PHYSICIAN: |
FURLONG,
NEILA
465-86-8819
7/19/01
DANIEL KRAMPITZ,
M.D.
|
MRI
OF THE BRAIN:
|
CLINICAL
HISTORY: Headaches, difficulty speaking and swallowing and
possibley recent seizure. The patient gives a history of
non-small cell carcinoma of the
lung with brain metastases and apparently has undergone previous
gamma knife
surgery.
|
TECHNIQUE: T1-weighted
images were obtained in the
sagittal and axial
planes. FLAIR and T2-weighted axial
images were obtained along with a gradient echo coronal sequence and a
diffusion sequence. Contrast was not administered.
|
|
COMPARISON: None.
|
FINDINGS:
| 1. |
There is diffuse prominence of the
ventricles and extra-axial
spaces greater than expected for the patient's age. There is
markedly extensive T2 signal abnormality within the white matter of both
cerebral hemispheres. This may be related to previous radiation
and/or chemotherapy. More focal low attenuation is present in the
left anterior frontal lobe and there is a small focus of susceptibility
artifact in the subcortical region of the left frontal lobe, which may reflect
minimal blood products or calcification. Contrast was unfortunately
not administered. I do not see obvious evidence of mass
effect. No
subdural or
epidural
hematoma is
detected. |
| 2. |
Diffusion imaging does not reveal
evidence of an acute
infarct. No shift of
midline structures is evident. There is no focal mass effect of the
ventricles. There are some prominent perivascular spaces
incidentally noted. |
| 3. |
There are normal flow voids within the
major intracranial vessels. Note is made of a
partially empty
sella. The visualized sinuses are grossly
clear. There is fluid or inflammatory debris within the
mastoid air cells on the
left. |
|
IMPRESSION:
| 1. |
Extensive T2 signal abnormality involving
the white matter of both cerebral hemispheres which may reflect a sequela of
radiation and/or chemotherapy. Hypertension and/or microvascular
ischemic change may contribute. Small focus of susceptibility
artifact in the left frontal lobe may reflect some minimal blood products or
clacification. Perhaps this is the region where previous
gamma surgery has been
performed. No obvious mass effect is
evident. Unfortunately, contrast was not
administered. There is more prominent low-signal intensity on
T1-weighted images within the left frontal lobe adjacent to this area of
susceptibility artifact. |
| 2. |
No evidence of acute
infarct on difficusion
imaging. |
| 3. |
Diffuse prominence to the
ventricles and extra-axial
spaces should reflect atrophy.
|
|
Ellis F. Robertson, M.D.
EFT/clm
D:
7/20/01 8:54AM
T: 7/20/01 8:56AM |
 |
/9840 N. Central Expressway, Suite 254, Dallas, TX
75231 ((214) 361-8018
7(214) 361-5264
|
|
