Date : 00.00.00
Name of the Patient : Abc Xyzw P. Mlmn / M / 67 yrs.
Referred by : Dr. Abc Xyzlkaka.
Examination : Intracranial and Neck M.R.A.
CLINICAL PROFILE :
C/O 2 episodes of right facial weakness (slurred speech).
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 ill-defined, hyperintense areas on the T2 Weighted images in bilateral lentiform nuclei, corona radiata, centrum semiovale and the periatrial deep white matter. These are iso to hypointense to the white matter on the T1 Weighted images and are suggestive of areas of ischemia/infarction.
An old cortical infarct is noted in the left posterior parietal cortex.
There is slight fullness of both the lateral ventricles. The third and the fourth ventricles are normal. There is prominence of the cerebral cortical sulci bilaterally. 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 vertebro-basilar system is ectatic with indentation upon the root exit zone of the left seventh and eighth cranial nerve complex. Indentation upon the left antero-lateral aspect of the pons is also noted.
There is slight irregularity of the distal segment of the right middle cerebral artery.
The petrous, cavernous and supraclinoid segments of the internal carotid arteries bilaterally show normal signal and calibre. The visualized anterior cerebral, left 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 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 lentiform nuclei bilaterally, corona radiata, centrum semiovale and the periatrial deep white matter.
2. Ectasia of the vertebro-basilar system with indentation upon the root exit zone of the left seventh and eighth cranial nerve complex and on the left antero-lateral aspect of the pons.
3. Slight irregularity of the distal segment of the right middle cerebral artery may be due to atherosclerosis.