Date : 00.00.00
Name of the Patient : Abc Xyzhai K. Paclmn / M / 40 yrs.
Referred by : Dr. Abc Xyzah.
Examination : Intracranial and Neck M.R.A.
CLINICAL PROFILE :
H/O left sided hemiparesis 8-10 years back.
H/O giddiness with vomiting and fall with LOC for few minutes and forgetfulness 3 months back.
Now C/O tingling in the RUE and gait ataxia.
The brain was screened with 5 mm thick T2 Weighted axial images and 5 mm thick T1 Weighted sagittal 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 the right cerebellar hemisphere, inferiorly, (along the distribution of the right posterior inferior cerebellar artery), in the left cerebellar hemisphere, superiorly and inferiorly (along the distribution of the left superior cerebellar artery and left posterior inferior cerebellar artery). The cerebellar vermis is also involved. These lesions appear hypointense on the T1 Weighted images.
Both the lateral, third and the fourth ventricles are normal. The basal cisternal spaces are unremarkable. There is no shift of the midline structures.
INTRACRANIAL MRA :
The left vertebral artery appears smaller in calibre as compared to the right and is most likely 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, right 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 vertebral artery in the neck also appears hypoplastic as compared to the right.
The common carotid arteries and their bifurcations are unremarkable. There are no vessel wall irregularities or stenosis of the vessels noted.
1. Altered signal in the cerebellar hemispheres bilaterally represent old infarcts.
2. Hypoplastic left vertebral artery.
3. No other significant abnormality is detected on the intracranial and neck MRA on this study.