Date : 00.00.00
Name of the Patient : Abc Xyzarmlmn / F / 41 yrs.
Referred by : Dr. Abc Xyzpta.
Examination : Intracranial and Neck M.R.A.
CLINICAL PROFILE :
C/O headaches on and off and speech disturbances since 3 months.
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.
There is no focal area of altered signal intensity within the brain parenchyma.
Both the lateral, third and the fourth ventricles are normal. The basal cisternal spaces are unremarkable. There is no shift of the midline structures.
Inflammatory changes are seen within the mastoid air cells, maxillary sinuses and sphenoid sinus.
INTRACRANIAL MRA :
The A1 segment of the right anterior cerebral artery is hypoplastic.
The petrous, cavernous and supraclinoid segments of the internal carotid arteries bilaterally show normal signal and calibre. The visualized left anterior cerebral, middle cerebral, basilar, vertebral and posterior cerebral arteries also show normal signal, calibre and wall margins. No obvious aneurysm or vascular malformation is identified.
NECK MRA :
The right vertebral artery is formed by two vessels arising from the right subclavian artery and uniting approximately 2.0 cms proximal to the right common carotid bifurcation.
The right common carotid artery and its extracranial branches appear normal.
There is flattening of the bulb of the left common carotid artery. A filling defect is noted along the medial wall of the distal left common carotid artery and the proximal left internal carotid artery. Mild stenosis of the origin of the left internal and external carotid arteries is noted.
The MRA features are suggestive of :
1. An anomalous origin of the right vertebral artery as described.
2. Flattening of the bulb of the left common carotid artery with a probable atherosclerotic plaque along the medial wall of the distal left common carotid artery and the proximal left internal carotid artery with resultant mild stenosis of the vessels as described.
3. No focal parenchymal lesion is identified in the brain.
As compared to the previous MRI (study no:00003) dated 00.00.00, there is no significant change noted.