Mid brain infarction (MR).

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:
•    An illdefined area in the left side of the mid brain reaching down to the junction between pons and mid brain (seen in image 15 coronal view T2 sequence) otherwise it could not be delineated well in the rest of sequences.

-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. Septum is in midline.  There is no midline shift.
-Basal cisterns, cortical sulci and gyri are normal in appearance.
-Sella is normal in appearance.
-Corpus callosum shows normal MR morphology.
-Cerebellum shows normal signal intensities.
-Fourth ventricle is normal in size and is midline in position.
-MR angiography reveals normal course, caliber and outlines of vessels of bilateral CA, ACA, MCA, PCA and their peripheral branches. Vertebro basilar trunk is also normal in appearance.
-The superior sagittal sinus, straight sinus, bilateral transverse sinuses,  their confluence, bilateral sigmoid sinuses and parts of internal jugular vein visualized, show normal course, caliber and outlines. No obvious evidence of any venous sinus thrombosis is seen at present.

OPINION:
•    In light of above mentioned MR data and history given; picture is suggestive of brain stem infarction mostly situated in the left mid brain till reaching junction between it and pons for clinical correlation.

Reported By : DR.MOHAMMED MOHYELDIN    
              Consultant-Radiologist