Date : 00.00.00
Name of the Patient : Abc Xyzlal lmn / M / 57 yrs.
Referred by : Dr. Abc Xyzauhan.
Examination : Intracranial and Neck M.R.A.
CLINICAL PROFILE :
C/O weakness of the LLE since 1 month.
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 a subtle hyperintense signal on the T2 Weighted images in the medulla. This is isointense to normal white matter on the T1 Weighted images and would most likely represent ischemic change.
Both the lateral, third and the fourth ventricles are normal. The basal cisternal spaces are unremarkable. There is no shift of the midline structures.
Incidental note is made of mild inflammatory changes in the ethmoidal air cells.
INTRACRANIAL MRA :
There is slight attenuation of the distal segment of the P2 segment of the left posterior cerebral artery for approximately 1.0 cm and may be due to atherosclerotic changes. The distal right posterior cerebral artery is not well identified.
The right vertebral artery is hypoplastic.
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 right 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 is also 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 medulla would represent ischemic change.
2. Slight attenuation of the distal portion of the P2 segment of the left posterior cerebral artery may be due to atherosclerotic changes. The distal right posterior cerebral artery is not well-defined.