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ke/bv/nl/nl
/59 Date : 00.00.00

Name of the Patient : Abc XyzSlmn / M / 51 yrs.
Referred by : Dr. Abc Xyzhta.
Examination : M.R.I. of the Brain and
Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O speech disturbance on 00.00.00.
C/O momentary numbness in the LUE and LLE in the last week of August 0000.
Known diabetic.

EXAMINATION :

M.R.I. of the brain was performed using the following parameters:

5 mm thick T1 Weighted, proton and T2 Weighted axial images.

5 mm thick FLAIR coronal images.

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

OBSERVATION :

BRAIN :

There is an ill-defined, hypointense area on the T1 Weighted images in the right inferior cerebellar hemisphere near the midline and the inferior vermis. This is seen to turn hyperintense on the proton and T2 Weighted images and represents an old infarct (scans 105.4, 104.4, 102.4).

Hyperintense areas are seen in the right posterior parietal region best appreciated on the FLAIR coronal images (scans 106.3, 106.4) and these represents ischemic changes.

There is asymmetrical prominence of the right lateral ventricle - a normal variant.

The left lateral, third and the fourth ventricles are normal. The basal cisternal spaces are unremarkable. There is no shift of the midline structures.

The antero-posterior dimensions of the eyeballs are increased as compared to normal and can be seen with high myopia.

Incidental note is made of a right maxilary polyp.

INTRACRANIAL MRA :

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

NECK MRA :

There is a small filling defect in the posterior aspect of the left common carotid artery just prior to the bifurcation and may represent atherosclerotic plaque. A similar smaller plaque is seen in the left internal carotid artery 1 1/2 cms from the bifurcation.

The right common carotid artery and its extracranial branches appear normal. There are no vessel wall irregularities or stenosis of the vessels noted.

IMPRESSION :

1. An old infarct in the right inferior cerebellar hemisphere near the midline and the inferior vermis.

2. Ischemic changes in the right posterior parietal region.

3. An atherosclerotic plaque in the posterior aspect of the left common carotid artery just prior to the bifurcation and left internal carotid artery 1 1/2 cms from the bifurcation.

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