Date : 00.00.00
Name of the Patient : Abc XyzK. Bholmn / M / 32 yrs.
Referred by : Dr. Abc Xyzatil.
Examination : Intracranial and Neck M.R.A.
CLINICAL PROFILE :
C/O bilateral ptosis with difficulty in speech, giddiness and headaches since 11-12 days.
The brain was screened with 5 mm thick T2 Weighted axial and FLAIR coronal images.
Intracranial and neck MRA were performed with 3D TOF and 2D TOF sequences, respectively.
There are hyperintense areas on the T2 Weighted and FLAIR images in the occipital lobes and the cerebellar hemispheres bilaterally. Similar areas are also noted in the left thalamus and in the midbrain. These would represent areas of ischemia/infarction.
Both the lateral, third and the fourth ventricles are normal. The basal cisternal spaces are unremarkable. There is no shift of the midline structures.
INTRACRANIAL MRA :
There is narrowing of the posterior cerebral artery on the left side. This could be due to ? vasculitis. (Film II, marked on new data).
The petrous, cavernous and supraclinoid segments of the internal carotid arteries bilaterally show normal signal and calibre. The visualized anterior cerebral, middle cerebral, basilar, vertebral and right posterior cerebral arteries also show normal signal, calibre and wall margins. No obvious aneurysm or vascular malformation is identified.
NECK MRA :
The common carotid arteries and their extracranial branches appear normal bilaterally. There are no vessel wall irregularities or stenosis of the vessels noted.
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1. Altered signal in the occipital lobes, the cerebellar hemispheres bilaterally, in the left thalamus and in the midbrain would represent areas of ischemia/infarction.
2. Narrowing of the posterior cerebral artery on the left side with irregular outline may be due to ? vasculitis.