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Date : 00.00.00

Name of the Patient : Abc Xyzn R. Nilmn / M / 31 yrs.
Referred by : Dr. Abc Xyziya.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O giddiness with vomiting on 00.00.00 with left sided hemiplegia since then.
Patient is in altered sensorium.

EXAMINATION :

The brain was screened with 5 mm thick T2 Weighted axial images.
Intracranial MRA was performed with 3D TOF sequence.

The study could not be completed as the patient was not very co-operative and could not be sedated as per the referring physicians instruction.

OBSERVATION :

The T2 Weighted axial images of the brain reveal an ill-defined hyperintense signal in the right cerebellar hemisphere, posteriorly, in the pons and at the junction of the midbrain and pons, centrally, in the right cerebral peduncle, right thalamus and in the right temporo-parietal region. This signal change suggest ischemic changes, in the given clinical setting. Limited MRA sequence which was possible identifies the cavernous and supraclinoid segments of the internal carotid arteries, proximal anterior and middle cerebral arteries and the posterior cerebral arteries bilaterally. These vessels do not reveal significant feature of note. The distal basilar artery is not well identified on the collapsed angiograpy images.
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Both the lateral, third and the fourth ventricles are normal. The basal cisternal spaces are unremarkable.There is no shift of the midline structures.

IMPRESSION :

Altered signal in the right cerebellar hemisphere, posteriorly, in the pons and at the junction of the midbrain and pons, centrally, in the right cerebral peduncle , right thalamus and in the right temporo-parietal region most likely represents recent ischemic lesions, in the given clinical setting. There is no obvious haemorrhage noted.

The MR angio sequences needs to be repeated when the patient is co-operative.


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