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ke/sb/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzee Malmn / F / 80 yrs.
Referred by : Dr. Abc Xyzgaonkar.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O giddiness since 1 month.

EXAMINATION :

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.

OBSERVATION :

There are hyperintense areas on the T2 Weighted images in thalami bilaterally, lentiform nuclei, corona radiata, centrum semiovale and the periventricular deep white matter and are ischemic in etiology.

There is blunting of the right cerebral peduncle.

The left Sylvian cistern and the sulcal spaces in the
left temporo-parietal and bilateral occipital regions are prominent, probably the result of previous vascular insult.

Lacunar infarcts are seen in the left internal capsule, right corona radiata and genu of the internal capsule on either side.

There is mild to moderate dilatation of both the lateral ventricles. The third and fourth ventricles are normal. There is prominence of the cerebral cortical sulci and cerebellar folia bilaterally.

The basal cisternal spaces are unremarkable. There is no shift of the midline structures.

Incidentally noted is an empty sella and inflammatory changes in the ethmoidal air cells and sphenoid sinus.
..2/.






INTRACRANIAL MRA :

There is slight irregularity of the left middle cerebral artery. Paucity of the left Sylvian vessels is noted. The A1 segment of the right anterior cerebral artery is hypoplastic. The vertebro-basilar system is ectatic. Concentric narrowing of the cavernous and supraclinoid segments of the right internal carotid artery is noted.

The petrous, cavernous and supraclinoid segments of the left internal carotid artery shows normal signal and calibre. The visualized left anterior cerebral, right 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 left internal carotid artery is tortuous.

The left vertebral artery is smaller in calibre as compared to the right.

The common carotid arteries and their extracranial branches appear normal bilaterally. There are no vessel wall irregularities or stenosis of the vessels noted.

IMPRESSION :

1. Altered signal in bilateral thalami, lentiform nuclei, corona radiata, centrum semiovale and the periventricular deep white matter are ischemic in etiology.

2. Lacunar infarcts in the left internal capsule, right corona radiata and genu of the internal capsule on either side.

3. Slight irregularity of the left middle cerebral artery.
..3/.






- 3 - Scan-00008

4. Paucity of the left Sylvian vessels.

5. Concentric narrowing of the cavernous and supraclinoid segments of the right internal carotid artery may be due to atherosclerotic changes.

6. Cerebral cortical and cerebellar atrophy.
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