Date : 00.00.00
Name of the Patient : Abc XyzVithalmn / F / 47 yrs.
Referred by : Dr. Abc Xyzdar.
Examination : M.R.I. of the Brain and
Intracranial and Neck M.R.A.
CLINICAL PROFILE :
C/O recent onset of seizures.
C/O paresthesias in the right hand.
M.R.I. of the brain was performed using the following parameters:
5 mm thick T1 Weighted, proton and T2 Weighted axial images.
5 mm thick FLAIR coronal images.
Intracranial and neck MRA were performed with 3D TOF and 2D TOF sequences, respectively.
There are multiple well-defined areas of hypointensity on the T1 Weighted images which turn hyperintense on the proton, T2 Weighted and FLAIR images within the white matter in the fronto-parietal lobes bilaterally, left temporal lobe, periatrial white matter bilaterally, within the left lateral aspect of the pons and the lateral aspect of the right cerebral peduncle. A few of these lesions are elongated and have a perivenular distribution.
An area of marked hypointensity on the T1 Weighted images which turns hyperintense on the proton and T2 Weighted images is noted within the white matter in the left frontal lobe (antero-superior to the left frontal horn). Note is also made of perilesional edema.
There is mild fullness of both the lateral and third ventricles. Also seen is mild prominence of the cerebral cortical sulci and cerebellar folia bilaterally.
There is a punctate signal void lesion on all the pulse sequences within the right cerebellar hemisphere which may represent a venous angioma.
The fourth ventricle is normal. The basal cisternal spaces are unremarkable. There is no shift of the midline structures.
INTRACRANIAL MRA :
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 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. The left common carotid artery arises from the right brachiocephalic artery.
- 3 - Scan-00007
The MRI features are suggestive of multiple areas of altered signal within the white matter in the fronto-parietal lobes bilaterally, left temporal lobe, periatrial white matter bilaterally, within the left lateral aspect of the pons and the lateral aspect of the right cerebral peduncle as described. These most likely represent plaques of demyelination (less likely to be ischemic in etiology). The lesion within the white matter in the left frontal lobe (antero-superior to the left frontal horn) may represent an acute plaque of demyelination.
The left common carotid artery arises from the right brachiocephalic artery. No other significant abnormality is detected in the intracranial and neck MRA on this study.