Date : 00.00.00
Name of the Patient : Abc Xyzc Dslmn / M / 68 yrs.
Referred by : Dr. Abc Xyzndhi.
Examination : Intracranial and Neck M.R.A.
CLINICAL PROFILE :
H/O fever with giddiness and blackouts since 3-4 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 ill-defined, hypointense areas on the T1 Weighted images in the cortex and subcortical white matter in the right high frontal region. This lesion appears hyperintense on the T2 Weighted images and represents an area of cystic encephalomalacia, most likely a sequelae of previous vascular insult. Resultant focal dilatation of the body of the right lateral ventricle is noted.
There is mild dilatation of both the lateral and third ventricles. The fourth ventricle is normal. There is prominence of the cerebral cortical sulci bilaterally. The basal cisternal spaces are unremarkable. There is no shift of the midline structures.
INTRACRANIAL MRA :
There is irregularity and narrowing of the distal segments of the vertebral arteries bilaterally and the proximal segment of the basilar artery. The left posterior cerebral artery is slightly attenuated.
The petrous, cavernous and supraclinoid segments of the internal carotid arteries bilaterally show normal signal and calibre. The visualized anterior cerebral, middle cerebral and right posterior cerebral arteries also show normal signal, calibre and wall margins. No obvious aneurysm or vascular malformation is identified.
NECK MRA :
There is seen slight irregularity of the terminal left common carotid artery along its anterior wall which may suggest an atherosclerotic plaque in that region. Resultant mild stenosis of the terminal left common carotid artery is noted. The right common carotid artery and its bifurcation and the vertebral arteries are unremarkable.
1. Area of cystic encephalomalacia, most likely a sequelae of previous vascular insult, in the cortex and subcortical white matter in the right high frontal region.
2. Irregularity and narrowing of the distal segments of the vertebral arteries bilaterally and the proximal segment of the basilar artery may suggest atherosclerotic changes.
3. An atherosclerotic plaque along anterior wall of the terminal left common carotid artery with slight irregularity and stenosis of the same.