Date : 00.00.00
Name of the Patient : Abc Xyzl Mlmn / M / 69 yrs.
Referred by : Dr. Abc Xyzhru.
Examination : Intracranial and Neck M.R.A.
CLINICAL PROFILE :
H/O single episode of momentary blackout 3-4 days back.
C/O tingling in the head since then.
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 are hyperintense areas on the T2 Weighted images in the frontal and parietal periventricular white matter, bilaterally.
There is moderate dilatation of both the lateral, third and the fourth ventricles. Turbulence is noted in the superior portion of the fourth ventricle, aqueduct and third ventricle.
There is mild prominence of the cerebral cortical sulci.
The basal cisternal spaces are unremarkable. There is no shift of the midline structures.
Incidental note is made of an empty sella, bilateral maxillary polyps and inflammatory changes in the ethmoidal air cells and sphenoid and frontal sinuses.
INTRACRANIAL MRA :
There is hypoplasia of the A1 segment of the left anterior cerebral artery. The left vertebral artery is hypoplastic.
The petrous, cavernous and supraclinoid segments of the internal carotid arteries bilaterally show normal signal and calibre. The visualized right anterior cerebral, middle cerebral, basilar, right vertebral and posterior cerebral arteries also show normal signal, calibre and wall margins. No obvious aneurysm or vascular malformation is identified.
NECK MRA :
The left vertebral artery in the neck is also hypoplastic.
The common carotid arteries and their extracranial branches appear normal bilaterally. There are no vessel wall irregularities or stenosis of the vessels noted.
1. Areas of ischemia/infarction in the frontal and parietal periventricular deep white matter.
2. Moderate dilatation of the ventricular system which is disproportionate to the degree of cerebral atrophy. Normal pressure hydrocephalus should be ruled out.
3. No significant abnormality is detected on the intracranial and neck MRA on this study.