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Diagnosis of a patient based on this brain MRI?


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Alright I guess I'll give it a try considering I'm a rads resident but haven't done MR yet.

 

The only thing I notice on this T1 weighted image is enlarged/dilated lateral ventricle so the diagnosis would be: hydrocephalus. The cause of the hydrocephalus??? *shrug* dunno.

 

On this single image I do not see any obstructive lesion, however obviously this is still be a possibility. Maybe she has a colloid cyst (common finding) or some mass lesion obstructing the foramen of monro with resultant obstruction of CSF flow (hence the back up of CSF and hydrocephalus), but you'd like to see a T2 sequence for that and obviously axial slices.

 

Dilatation of ventricles does not Alzheimer's make. I would not even include that on a report. Alzheimer's is a clinical and pathological diagnosis. Someone who has had an infarct or age-related cerebral atrophy can get dilatation of their ventricles. This in no way insinuates that this person has, or will have, Alzheimer's. The reason to get any scan of the brain (CT or MR) if you suspect Alzheimer's is to rule out any structural lesion that may be causing the memory impairment - never to diagnose Alzheimer's.

 

Hope this helps.

Someone correct me if I've stated something incorrectly - still learning here!!!

 

As for blood - the "white stuff" you are seeing thats taking on a gyroform appearance is that - white matter of the gyri!

 

 

Edited to add: I'm interested in knowing the answer - please PM me if/when you get it! Thanks!

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