Date : 00.00.00
Name of the Patient : Abc XyzSiddlmn / M / 66 yrs.
Referred by : Dr. Abc Xyzlkaka.
Examination : Intracranial and Neck M.R.A.
CLINICAL PROFILE :
C/O headaches (mild), vomiting with giddiness and gait imbalance since 4 days.
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 in the left cerebellar hemisphere, superiorly and in the left middle cerebellar peduncle on the T2 Weighted images. These are isointense to white matter on the T1 Weighted images and are suggestive of areas of recent ischemia/infarction.
A lacunar infarct is seen in the right cerebellar hemisphere, inferiorly and an old infarct is noted in the left cerebellar hemisphere, inferiorly.
There is moderate dilatation of both the lateral ventricles. The third and the fourth ventricles are normal. There is 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 right maxillary sinusitis.
INTRACRANIAL MRA :
The right vertebral artery is hypoplastic as compared to the left.
The petrous, cavernous and supraclinoid segments of the internal carotid arteries bilaterally show normal signal and calibre. The visualized anterior cerebral, 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 also appears 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. Altered signal in the left cerebellar hemisphere superiorly and in the left middle cerebellar peduncle are suggestive of areas of recent ischemia/infarction.
2. A lacunar infarct in the right cerebellar hemisphere.
3. An old infarct in the left cerebellar hemisphere, inferiorly.
4. Moderate dilatation of both the lateral ventricles.
5. No significant abnormality is detected on the intracranial and neck MRA on this study.