Date : 00.00.00
Name of the Patient : Abc Xylmn / F / 75 yrs.
Referred by : Dr. Abc Xyzah.
Examination : Intracranial and Neck M.R.A.
CLINICAL PROFILE :
C/O mild weakness on the left side of the body with speech disturbances at 4.00 P.M. on 00.00.00.
The brain was screened with 5 mm thick T2 Weighted axial and 5 mm thick FLAIR coronal images.
Intracranial and neck MRA were performed with 3D TOF and 2D TOF sequences, respectively.
There is an ill-defined, hyperintense area in the right temporo-occipito-parietal lobes on the T2 Weighted and FLAIR images. This is hypointense to white matter on the T1 Weighted images and is suggestive of an area of infarction.
Similar smaller areas are seen in the right centrum semiovale and body of the right caudate nucleus.
There is an intermediate signal intensity lesion in the petrous and cavernous portion of the internal carotid artery on the right side on the T2 Weighted images.
Note is made of an empty sella.
There is mild fullness of the ventricular system with prominence of the cerebral cortical sulci and cerebellar folia bilaterally.
The basal cisternal spaces are unremarkable. There is no shift of the midline structures.
INTRACRANIAL MRA :
There is non-visualization of the petrous, cavernous and supraclinoid portion of the right internal carotid artery from the level of the foramen magnum.
- 2 - Scan-00008
The right middle cerebral artery and right anterior cerebral artery appear to be filling from the left circulation. The right middle cerebral artery appears to be slightly narrow with paucity of the Sylvian branches. The distal aspect of the right posterior cerebral artery is not well-identified.
The petrous, cavernous and supraclinoid segments of the left internal carotid artery shows normal signal and calibre. The visualized left anterior cerebral, left middle cerebral, basilar, vertebral and left posterior cerebral arteries also show normal signal, calibre and wall margins. No obvious aneurysm or vascular malformation is identified.
NECK MRA :
There is non-visualization of the internal carotid artery from the level of its bifurcation on the right side.
The common carotid arteries per se are unremarkable as is the left internal carotid artery.
The MRA features are suggestive of :
1. Altered signal in the right temporo-occipito-parietal lobes most likely represents a fresh infarct.
2. Non-visualization of the right internal carotid artery in its entirety.