Date : 00.00.00
Name of the Patient : Abc Xyzas lmn / M / 73 yrs.
Referred by : Dr. Abc Xyzndesha.
Examination : Intracranial and Neck M.R.A.
CLINICAL PROFILE :
C/O mild weakness of the RUE and RLE since 00.00.00
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 an ill-defined hyperintense area in the left occipital lobe on the T2 Weighted images. This is hypointense to normal white matter on the T1 Weighted images and represents an area of infarction. The cortex is also involved. Similar areas are seen within the splenium of the corpus callosum on the left side.
Hyperintense areas are also noted on the T2 Weighted images in the pons, bilateral corona radiata and periatrial deep white matter and are probably ischemic in etiology.
There is 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 :
The right vertebral artery is hypoplastic with tortuousity of the vertebro-basilar system.
There is slight irregularity of the left posterior cerebral artery.
The petrous, cavernous and supraclinoid segments of the internal carotid arteries bilaterally show normal signal and calibre. The visualized anterior cerebral, middle cerebral, basilar, left vertebral and right posterior cerebral arteries also show normal signal, calibre and wall margins. No obvious aneurysm or vascular malformation is identified.
NECK MRA :
A filling defect is noted along the posterior and lateral walls of the terminal left common carotid artery which may represent an atherosclerotic plaque.
The right common carotid artery appears normal. The right vertebral artery in the neck is also hypoplastic.
1. Areas of altered signal in the left occipital lobe and within the splenium of the corpus callosum on the left side represent areas of infarction, most likely recent.
2. Altered signal in the pons, bilateral corona radiata, periatrial deep white matter are also probably ischemic in etiology.
3. Slight irregularity of the left posterior cerebral artery.
4. Small filling defects along the posterior and lateral wall of the terminal left common carotid artery may represent an atherosclerotic plaque.