Brain Lesion seen after 46 years

 A 55 year old resident of durgapur came to the hospital with the chief complaints of vomitings, headache since 7 days.
On knowing his past history at the age of 9 years, suddenly he become subconsious and was taken to thre local hospital where he was kept under quarintine for 21 days and after 21 days he was allowed to roam outside. Asper his words he was diagnosed as polio at that time but as per records which he  shows to us he was diagnosed as right UL , LL limb paresis due to post meningitis or post encephalitis (but this is a government issued card but not a doctor issued card).


On General examination Patient was conscious, oriented to time palce and person and cooperative.  patient is moderately built and moderately nourished.

On Systemic examination:

Inspection:




Minimental Mental State Examination score: 29/30

Reflexes:
                                  Right                            Left
Knee reflex:            Exagerrated                No reflex                      
Ankle reflex:            Normal                       No reflex
Plantar Reflex:        Absent                        Absent
Triceps Reflex:      Exagerrated                 Normal
Biceps Reflex:      Exagerrated               Normal
Brachio-radials:    Exagerrated               Normal

Power of the muscles:
                                       Right                            Left
Hamstrings Muscles      Grade 4                        Grade 5
Biceps                            Grade 4                        Grade 5
Triceps                           Grade 4                        Grade 5
Gluteas maximus             Grade 4                        Grade 5
Gait:  

Investigations:
CT Scan Of the brain:






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