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Date : 00.00.00

Name of the Patient : Abc Xyzi Plmn / F / 60 yrs.
Referred by : Dr. Abc Xyzah.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O right sided weakness since 20-25 days.
Known hypertensive/diabetic.

EXAMINATION :

The brain was screened with 5 mm thick T2 Weighted axial images and 5 mm thick FLAIR coronal images.

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

SOME IMAGES SHOW PATIENT MOTION.

OBSERVATION :

There are ill-defined, hyperintense areas on the T2 Weighted and FLAIR images in the posterior parietal periventricular white matter bilaterally, right lentiform nucleus, left thalamus and in the centrum semiovale bilaterally. These lesions appear iso to hypointense to normal white matter on the T1 Weighted images and most likely represent ischemic lesions.

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 no shift of the midline structures.

Inflammatory changes are noted in the ethmoidal air cells and mastoid air cells bilaterally.

INTRACRANIAL MRA :

The intracranial segment of the left vertebral artery appears hypoplastic.



There is seen a very small, subcentimeter, focal hyperintense lesion along the frontal polar branch of the left anterior cerebral artery. This lesion is persistant on all the reconstructed angiographic images and is suspicious for an aneurysm (less likely to represent the bend of a vessel).

The petrous, cavernous and supraclinoid segments of the internal carotid arteries bilaterally show normal signal and calibre. The visualized right anterior cerebral, middle cerebral, basilar, right vertebral and posterior cerebral arteries also show normal signal, calibre and wall margins. No vascular malformation is identified.

NECK MRA :

The left vertebral artery in the neck also appears hypoplastic. The common carotid arteries and their bifurcations and the right vertebral artery are unremarkable.

There are no vessel wall irregularities or stenosis of the vessels noted.

IMPRESSION :

1. Altered signal in the posterior parietal periventricular white matter bilaterally, right lentiform nucleus, left thalamus and in the centrum semiovale bilaterally most likely represent ischemic lesions.

2. A very small, subcentimeter, focal hyperintense lesion along the frontal polar branch of the left anterior cerebral artery and is suspicious for an aneurysm (less likely to represent the bend of a vessel).


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