/22 Date : 00.00.00
Name of the Patient : Abc Xyzrlmn / M / 38 yrs.
Referred by : Dr. Abc Xyzah.
Examination : Intracranial and Neck M.R.A.
CLINICAL PROFILE :
C/O headaches with giddiness since 2 years.
Now C/O weakness of the LUE, heaviness and paresthesias since 15 days.
Also C/O diplopia on the left side.
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 evidence of an area of hyperintensity on the T2 Weighted images involving the cortical gray and white matter in the right temporo-occipital region. This most likely represents an area of ischemia/infarction (watershed of the right middle cerebral and right posterior cerebral arteries).
Lacunar infarcts (isointense to CSF) are seen within the right thalamus and left cerebellar hemisphere.
There is mild prominence of the cerebellar folia bilaterally.
Both the lateral, third and the fourth ventricles are normal. The basal cisternal spaces are unremarkable. There is no shift of the midline structures.
Inflammatory changes are seen within the right maxillary sinus and ethmoidal air cells.
INTRACRANIAL MRA :
The calibre of the cavernous segment of the right internal carotid artery is smaller as compared to the left side.
The petrous and supraclinoid segments of the internal carotid arteries bilaterally and cavernous segment of the left internal carotid artery shows 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 :
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 within the right temporo-occipital region most likely represents an area of ischemia/infarction (watershed of the right middle cerebral and right posterior cerebral arteries).
2. Lacunar infarcts within the right thalamus and left cerebellar hemisphere.
3. Smaller calibre of the cavernous segment of the right internal carotid artery as compared to the left side.