/20 Date : 00.00.00
Name of the Patient : Abc Xyzh Andlmn / M / 48 yrs.
Referred by : Dr. Abc Xyzri / Dr. Abc Xyznghal.
Examination : Intracranial and Neck M.R.A.
CLINICAL PROFILE :
H/O left hemiplegia on 00.00.00.
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 fairly well-circumscribed, hyperintense area on the T2 Weighted images in the right corona radiata. This is hypointense to the normal white matter on the T1 Weighted images and would represent an infarct.
A lacunar infarct (isointense to CSF on all the pulse sequences) is seen anterior to the above mentioned lesion and the right lentiform nucleus.
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 right maxillary polyp.
INTRACRANIAL MRA :
There is paucity of the Sylvian branches of the left middle cerebral artery.
The left 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, right 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.
Atherosclerotic plaques are noted along the postero-medial walls of the proximal internal carotid arteries bilaterally, just distal to the common carotid bifurcation. Resultant mild stenosis of these vessels is noted.
The common carotid arteries and their extracranial branches appear normal bilaterally.
1. Altered signal in the right corona radiata would represent a subacute infarct.
2. A lacunar infarct in the right corona radiata, anteriorly
and the right lentiform nucleus.
3. Atherosclerotic plaques along the postero-medial walls of the proximal internal carotid arteries bilaterally, just distal to the common carotid bifurcation.