sb/ke/rg.
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Name of the Patient : Abc XyzDlmn / M / 58 yrs.
Referred by : Dr. Abc Xyzstak.
Examination : Intracranial and Neck M.R.A.
CLINICAL PROFILE :
H/O left hemiparesis on 00.00.0000 which is recovered partially.
Known diabetic/hypertensive. On Rx.
EXAMINATION :
The brain was screened with 5 mm thick T2 Weighted axial images.
Intracranial and neck MRA were performed with 3D TOF and 2D TOF sequences, respectively.
OBSERVATION :
There is an ill-defined, predominantly hypointense signal on the T2 Weighted images in the right posterior parietal region. This lesion appears iso to hypointense to normal white matter on the T1 Weighted images. Perilesional, CSF signal intensity lesions are noted which may represent encephalomalacic areas. This lesion represents an ischemic lesion with haemoglobin breakdown products within.
A hyperintense signal on the T2 Weighted images is noted in the left temporo-occipital cortex which also represents an old ischemic lesion.
There is mild dilatation of both the lateral and the third ventricles. The fourth ventricle is normal. There is slight prominence of the cerebral cortical sulci and cerebellar folia bilaterally. The basal cisternal spaces are unremarkable. There is no shift of the midline structures.
Inflammatory changes are noted in the left maxillary antrum.
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- 2 - Scan-00003/5
INTRACRANIAL MRA :
There is irregularity and narrowing of the distal left vertebral artery and the right middle cerebral artery with slight attenuation of the Sylvian branches of the right middle cerebral artery.
Suspicious slight concentric narrowing of the distal cavernous segment of the internal carotid artery is noted bilaterally.
The petrous and supraclinoid segments of the internal carotid arteries bilaterally show normal signal and calibre. The visualized anterior cerebral, basilar, right vertebral and posterior cerebral arteries also show normal signal, calibre and wall margins. No obvious aneurysm or vascular malformation is identified.
NECK MRA :
The left vertebral artery is seen to be form by multiple vascular channels in the distal third of the neck and it appears slightly smaller in calibre as compared to the right.
There is approximately 7.0 to 8.0 mms segments of the significant stenosis of the proximal right internal carotid artery about 1.0 cms distal to the right common carotid bifurcation.
The right common carotid bifurcation per se, left common carotid artery and its bifurcation and the right vertebral artery is unremarkable.
IMPRESSION :
1. Altered signal in the right posterior parietal region
represent an old ischemic lesion with haemoglobin breakdown products and encephalomalacic changes within.
2. Altered signal in the left temporo-occipital cortex also represents an old ischemic lesion.
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- 3 - Scan-00003/5
3. Irregularity and narrowing of the distal left vertebral artery and the right middle cerebral artery with slight attenuation of the Sylvian branches of the right middle cerebral artery may be due to atherosclerotic changes.
4. Suspicious slight concentric narrowing of the distal cavernous segment of the internal carotid artery bilaterally.
5. The left vertebral artery is seen to be form by multiple vascular channels in the distal third of the neck.
6. An approximately 7.0 to 8.0 mms segments of the significant stenosis of the proximal right internal carotid artery about 1.0 cms distal to the right common carotid bifurcation, may also be due to atherosclerotic changes.