Date : 00.00.00
Name of the Patient : Abc XyzNalalmn / M / 42 yrs.
Referred by : Dr. Abc Xyzlkaka.
Examination : Intracranial and Neck M.R.A.
CLINICAL PROFILE :
C/O recurrent stroke (3 attacks) on the left side within the last 2 years and on the right side 2 months back.
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 hyperintense area in the right corona radiata and centrum semiovale on the T2 Weighted images and is probably ischemic in etiology.
Areas which are iso to hyperintense to CSF are seen in the right lentiform nucleus and left corona radiata.
There is fullness of the third and both the lateral ventricles.
There is prominence of the cerebral cortical sulci and the cerebellar folia bilaterally.
There is blunting of the right cerebral peduncle.
The fourth ventricle is normal. The basal cisternal spaces are unremarkable. There is no shift of the midline structures.
INTRACRANIAL MRA :
There is tapering of the distal portion of the right middle cerberal artery with vessel wall irregularity. There is a paucity of vessels in the right Sylvian fissure.
The left posterior cerebral artery is continuation of the left posterior communicating artery.
The A1 segment of the left anterior cerebral artery is hypoplastic.
The petrous, cavernous and supraclinoid segments of the internal carotid arteries bilaterally show normal signal and calibre. The visualized right anterior cerebral, left middle cerebral, basilar, vertebral and right 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.
The MRA features are suggestive of :
1. An area of altered signal intensity within the right corona radiata and centrum semiovale is most likely ischemic in etiology (most likely an old infarct).
2. Lacunar infarcts in the right lentiform nucleus and left corona radiata.
3. Tapering of the distal portion of the right middle cerebral artery with a paucity of vessels in the right Sylvian fissure.
4. Hypoplastic A1 segment of the left anterior cerebral artery.