Date : 00.00.00
Name of the Patient : Abc Xyz Salmn / M / 60 yrs.
Referred by : Dr. Abc Xyzah.
Examination : Intracranial and Neck M.R.A.
CLINICAL PROFILE :
C/O visual defect bilaterally (inability to see to the extreme right and left, respectively since 1 week).
C/O tingling in the LUE since 1 week.
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 an ill-defined, hyperintense area on the T2 Weighted images along the right posterior parietal cortex and subcortical white matter. This lesion most likely represents a recent ischemic lesion.
There is a suspicious hypointense signal on the T1 Weighted sagittal images in the right posterior parietal deep white matter, which appears hyperintense on the T2 Weighted images and most likely represents an old ischemic lesion.
There is mild fullness of both the lateral ventricles.
The third and the fourth ventricles are normal. The basal cisternal spaces are unremarkable. There is slight prominence of the cerebral cortical sulci bilaterally. There is no shift of the midline structures.
Incidentally noted are inflammatory changes in the right maxillary antrum and a Thornwaldts cyst in the posterior pharyngeal wall.
INTRACRANIAL MRA :
The right vertebral artery and the A1 segment of the right anterior cerebral artery appear hypoplastic.
There is irregularity and narrowing of the mid segment of the right middle cerebral artery with resultant stenosis. The Sylvian branches of the right middle cerebral artery are however well identified.
The petrous, cavernous and supraclinoid segments of the internal carotid arteries bilaterally show normal signal and calibre. The visualized left anterior cerebral, left middle cerebral, basilar, left 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 in the neck is also hypoplastic.
The common carotid arteries and their bifurcations and the left vertebral artery are unremarkable. There are no vessel wall irregularities or stenosis of the vessels noted.
1. A recent ischemic lesion in the right posterior parietal cortex.
2. A suspicious old ischemic lesion in the right posterior parietal deep white matter.
3. Irregularity and narrowing of the mid segment of the right middle cerebral artery with resultant stenosis.