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Name of the Patient : Abc Xyzhandra lmn / M / 81 yrs.
Referred by : Dr. Abc Xyzhacker.
Examination : M.R.I. of the Brain and
Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O left sided hemiparesis since 4-5 days.
H/O similar complaints in October 0000, from which patient recovered.

EXAMINATION :

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 and Fast Scan (T2 *) coronal images.

Intracranial and neck MRA were performed with 3D TOF and 2D TOF sequences, respectively.

FEW IMAGES SHOW PATIENT MOTION.

OBSERVATION :

BRAIN :

Areas of hyperintensity on the proton, T2 Weighted and FLAIR images are seen within the periatrial white matter and white matter in the fronto-parietal lobes bilaterally and in the pons on the right side. These are iso to hypointense to normal white matter on the T1 Weighted images and are most likely ischemic in etiology.

There is mild fullness of the third and both the lateral ventricles. There is mild prominence of the basal cisternal spaces and cerebral cortical sulci and cerebellar folia bilaterally.
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The fourth ventricle is normal. The basal cisternal spaces are unremarkable. There is no shift of the midline structures.

Note is made of mild pansinusitis.

INTRACRANIAL MRA :

There is ectasia of the vertebro-basilar system.

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 left common carotid artery and brachiocephalic artery are seen to arise from a common trunk which is seen to arise from the aortic arch.

The right common carotid artery and its extracranial branches appear normal bilaterally. There are no vessel wall irregularities or stenosis of the vessels noted.

IMPRESSION :

The MRI features are suggestive of :

1. Areas of altered signal intensity within the periatrial white matter and white matter in the fronto-parietal lobes bilaterally and in the pons on the right side and these are most likely ischemic in etiology.

2. Ectasia of the vertebro-basilar system.

3. The left common carotid artery and brachiocephalic artery are seen to arise from a common trunk which is seen to arise from the aortic arch.



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