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ke/hs/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzna B. Plmn / F / 34 yrs.
Referred by : Dr. Abc Xyzndel.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O headaches with left sided hemiparesis and slurred speech on 00.00.00 which has recovered now.

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 is a hypointense area (hyperintense to CSF) on the T1 Weighted images in the right lentiform nucleus extending into the right corona radiata. This is seen to turn hyperintense on the T2 Weighted images. There is no surrounding edema or mass effect.

Both the lateral, third and the fourth ventricles are normal. The basal cisternal spaces are unremarkable. There is no shift of the midline structures.

Incidenteal note is made of a left maxillary polyp.

INTRACRANIAL MRA :

The calibre of the right internal carotid artery in its intracranial portion appears smaller as compared to the left. There is paucity of the right Sylvian branches and thinning with irregularity of the distal portion of the M1 segment of the right middle cerebral artery.

The A1 segment of the right anterior cerebral artery is hypoplastic (? flow signal attenuation).
..2/.






- 2 - Scan-00005


The petrous, cavernous and supraclinoid segments of the internal carotid arteries bilaterally show normal signal. The visualized left anterior cerebral, left 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 right common carotid artery and the right internal carotid artery is smaller in calibre as compared to the left side.

The right vertebral artery is seen to arise from the right common carotid artery. The left vertebral artery is seen to arise from the aortic arch.

IMPRESSION :

The MRA features are suggestive of

1. Altered signal in the right lentiform nucleus extending into the right corona radiata would represent an old infarct.

2. Smaller calibre of the right internal carotid artery in its intracranial portion as compared to the left.

3. Paucity of the right Sylvian branches with thinning and irregularity of the distal portion of the M1 segment of the right middle cerebral artery.

4. Hypoplastic A1 segment of the right anterior cerebral artery (? flow signal attenuation).

5. Smaller calibre of the right common carotid artery and the right internal carotid artery as compared to the left side in the neck.

6. The right vertebral artery is seen to arise from the right common carotid artery and the left vertebral artery is seen to arise from the aortic arch.





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