ke/hs/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyz Jethalmn / M / 42 yrs.
Referred by : Dr. Abc Xyzandel.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O headaches (frontal and left sided) since 1 1/2 years with decreased hearing on the left side.

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 are multiple, serpiginous and punctate hypointense areas in the left parafalcine frontal region on all the pulse sequences and would represent a vascular malformation. This lesion appears to be fed by the anterior cerebral artery which is prominent. A large draining vein is seen at its superior aspect and draining into the anterior portion of the superior sagittal sinus. There is suggestion of an aneurysmal dilatation of a vessel which measures approximately 2.2 cms in diameter. There is mild surrounding edema with mass effect and mild indentation on the frontal horn of the left lateral ventricle.

The right lateral, third and the fourth ventricles are normal. The basal cisternal spaces are unremarkable. There is no shift of the midline structures.

INTRACRANIAL MRA :

The anterior cerebral arteries appear prominent and are seen to feed the vascular malformation. A large draining vein is seen to join the anterior portion of the superior sagittal sinus. A twig from the left anterior cerebral artery is seen to be adjacent to the previously mentioned aneurysmal dilatation of a vessel.
- 2 - Scan-00004

The petrous, cavernous and supraclinoid segments of the internal carotid arteries bilaterally show normal signal and calibre. The visualized basilar, vertebral, middle and posterior cerebral arteries also show normal signal, calibre and wall margins.

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.

IMPRESSION :

The MRA features are suggestive of a vascular malformation in the left frontal region as described. This would represent an arterio-venous malformation with aneurysmal dilatation of a vessel.