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hs/sb/nl/nl.
/375 Date : 00.00.00

Name of the Patient : Abc Xyzhai Plmn / M / 50 yrs.
Referred by : Dr. Abc Xyzandel.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O headaches since 17-18 days.

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 multiple small bright foci on the T2 Weighted images within the white matter in the fronto-parietal lobes bilaterally and these are most likely ischemic in etiology.

There is mild prominence of the cerebral cortical sulci bilaterally. Also seen is mild fullness of the third and both the lateral ventricles.

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

INTRACRANIAL MRA :

There is flow signal attenuation within the proximal portion of the anterior cerebral arteries bilaterally. The A1 segment of the right anterior cerebral artery is not well visualized.

There is vessel wall irregularity of the distal aspect of the M1 segment of the left middle cerebral artery. Also seen is narrowing of the distal segment of the right vertebral artery.




The calibre of the right internal carotid artery is smaller as compared to the left side.

The petrous, cavernous and supraclinoid segments of the internal carotid arteries bilaterally show normal signal. The visualized right middle cerebral, basilar, left vertebral and posterior cerebral arteries also show normal signal, calibre and wall margins. No obvious aneurysm or vascular malformation is identified.

NECK MRA :

A filling defect along the posterior wall of the terminal left common carotid artery and proximal left internal carotid artery may represent an atherosclerotic plaque.

The right common carotid artery and its bifurcation appears normal. The vertebral arteries in the neck are unremarkable.

IMPRESSION :

The MRA features are suggestive of :

1. Foci of altered signal intensity within the white matter in the fronto-parietal lobes bilaterally and these are most likely ischemic in etiology.

2. Flow attenuation signal within the proximal portion of the anterior cerebral arteries bilaterally, with non-visualization of the A1 segment of the right anterior cerebral artery.

3. Narrowing of the distal segment of the right vertebral artery.

4. Vessel wall irregularity of the distal aspect of the M1 segment of the left middle cerebral artery.

5. An atherosclerotic plaque along the posterior wall of the terminal left common carotid artery and proximal left internal carotid artery.




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