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뇌손상 여부 여쭙니다. 해외거주중이라 급한상황입니다.

중뇌 왼쪽과 오른쪽 부종으로 보이는데 맞을까요. 현지 주치의선생님께선 검사를 더하자 하시는데... 모더나2차 맞고 몸이 급격히 안좋아졌고 복시 상지하지마비도 최근 증세입니다. 복시가 심해요. 일시귀국을 하려고 하는데 정확한 병명을 말씀하진 않으시고 검사를 더해보자고만...

There is a fairly circumscribed T1-weighted hypointense, T2-weighted hyperintense lesion measuring 1.4 x 1.4 X approximately 1.3 cm (axial dimension x craniocaudal extent) in the medial left thalamus extending into the left midbrain with mild perilesional oedema. There are two closely associated T1-weighted hypointense, T2-weighted hyperintense lesions measuring 0.5 x 0.5 cm in the central midbrain anterior to the cerebral aqueduct of sylvius and 0.5 x 0.5 cm in the paramedian upper right midbrain. Mild T2w signal prolongation along the inferior medial right thalamus may be part of perilesional oedema. Medial bulging of the left thalamus IS seen related to the lesion IS seen with mild focal mass effect on the third ventricle. No significant hydrocephalus is noted. Lesions show no significant enhancement post-contrast. No leptomeningeal enhancement is noted.

Radlink Diagnestic Imaging [S] Pte or aneurysm. MRA of the extracranial internal carotid and vertebral arteries show satisfactory signal and caliber with no significant stenosis. The left vertebral artery is dominant. The visualized osseous structures, orbits and pituitary fossa are unremarkable. A thin film of mucus is seen in the left frontal and bilatcral ethmoid air cells. No significant abnormality is seen at the craniovertebral junction.

Impression: Non-enhandng T1-weighted hypointense, T2-weighted hyperintense lesion measuring 1.4 x1.4x1.3 cm in the medial left thalamus with extensian to the left midbrain and two closely associated smaller 5 mm lesions in the central and paramedian right midbrain with mild perilesional cedema are noted. There is medial bulging of the left thalamus with mild mass effect an the third ventricle with no associated hydrocephalus. Differentials may include left thalamic and right midbrain gliomas, less likely demyelinating lesions. Histological correlation may be helpful. Follow-up imaging will be helpful assess for interval change. No acute infarct or intracranial hemorrhage is seen. MRA of the circle of Willis and extracranial internal carotid and vertebral arteries show no significant stenosis or abnormality.

답변

Re : 뇌손상 여부 여쭙니다. 해외거주중이라 급한상황입니다.
한홍준
한홍준 [전문의] 하이본병원
하이닥 스코어: 81
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2021.08.31
안녕하세요. 하이닥 신경외과 상담의 한홍준입니다.

올려주신 영상으로 보아 부종 소견은 있는 것으로 보이며 좀 더 정확히 알기 위해서는 추가 영상 검사를 요할 것으로 판단됩니다.
상기 소견만으로 정확한 병명을 알기는 어려울 것 같습니다.

 

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