Date : 00.00.00
Name of the Patient : Abc Xyzao Salgaolmn / M / 68 yrs.
Referred by : Dr. Abc Xyzbar.
Examination : Intracranial and Neck M.R.A.
CLINICAL PROFILE :
C/O giddiness with ataxia and speech disturbances.
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 area following CSF signal characteristics in the inferior aspect of the left cerebellar hemisphere and would represent an area of cystic encephalomalacia.
Hyperintense areas on the T2 Weighted images are seen within the corona radiata, centrum semiovale, lentiform nuclei and periventricular white matter bilaterally and the right thalamus.
Lacunar infarcts are seen in the lentiform nuclei, left cerebellar hemisphere and right corona radiata.
There is mild fullness of the ventricular system. There is slight prominence of the cerebral cortical sulci and cerebellar folia bilaterally.
There is no shift of the midline structures.
INTRACRANIAL MRA :
There is slight vessel wall irregularity of the P1 segment of both the posterior cerebral arteries, the M1 segment of the left middle cerebral artery and both anterior cerebral arteries.
The petrous, cavernous and supraclinoid segments of the internal carotid arteries bilaterally show normal signal and calibre. The visualized right middle cerebral, basilar and vertebral 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 MRI features are suggestive of :
1. Cystic encephalomalacia in the left cerebellar hemisphere, inferiorly.
2. Areas of hyperintensity on the T2 Weighted images within the corona radiata, centrum semiovale, lentiform nuclei and periventricular white matter bilaterally and the right thalamus and these are most likely ischemic in etiology.
3. Lacunar infarcts in the lentiform nuclei, left cerebellar hemisphere and right corona radiata.
4. Slight irregularity of the vessels involving the P1 segment of both the posterior cerebral arteries, the M1 segment of the left middle cerebral artery and both anterior cerebral arteries and this may represent atherosclerotic changes.