Hemorrhagic Brain.

PROTOCOL:
T2W – Sagittal & axial scans
T1W – Axial scans
FLAIR – Coronal scans
DW & T2FFE (Gradient) – Axial scans
3D TOF MR angiography of the circle of Willis vessels and MIP reconstruction.
MR venography protocol

FINDINGS:

-Revealed:
• Right parieto-temporal region sub acute intra parenchymal hematoma with mild surrounding peri focal edema and mild effacement of adjacent sulci.
• Mild mid line structure shift (2.7 mm).
• Multiple variable sized foci of hypo intensity are noted scattered in both basal ganglia; bilateral juxta cortical and corpus callosum. They are characterized by hypo intensity on all sequences and blooming effect on Gradient images; suggestive of old blood.
• Right middle cerebral artery as source of hematoma.
• Severely stenosed segment of left internal carotid artery.
• Attenuated peripheral branches of right middle cerebral artery if compared to the left one.
• Complete non visualization of the left transverse sinus with normal morphology of the rest of the MR venography.

-The rest of the brain Parenchyma shows normal grey white matter differentiation and signal intensities.  No focal mass lesion is seen.
-Lateral and third ventricles are normal in size and position. 
-Basal cisterns, cortical sulci and gyri are normal in appearance.
-Corpus callosum shows normal MR morphology.
-Brain stem and cerebellum show normal signal intensities.
-Fourth ventricle is normal in size and is midline in position.

OPINION:
• Right parieto-temporal region sub acute intra parenchyma hematoma for clinical correlation.
• Multiple variable sized hemorrhagic foci as mentioned above.


Reported By : DR.MOHAMMED MOHYELDIN
 Consultant-Radiologist
Report Status : Invalidated / Validated By :  Dr.Mohammed Mohyeldin