Name of the Patient : Abc Xyzlmn / M / 70 yrs.
Referred by : Dr. Abc Xyzlkaka.
Examination : Intracranial and Neck M.R.A.
CLINICAL PROFILE :
H/O weakness of the RLE, speech disturbances, diminished eyesight and memory impairment since 6-7 days.
Known hypertensive. On Rx.
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 are ill-defined, hyperintense areas on the T2 weighted images in the periventricular white matter bilaterally, pons in the midline and in the subcortical white matter in the left temporo-parietal region (scans 102.8-10). These most likely represent ischemic changes. _
Lacunar infarcts are noted in the thalami and corona radiata bilaterally.
There is mild fullness of both the lateral and the third ventricles. The fourth ventricle is normal. There is slight prominence of the cerebellar folia and cerebral cortical sulci bilaterally. The basal cisternal spaces are unremarkable. There is no shift of the midline structures.
INTRACRANIAL MRA :
The A1 segment of the right anterior cerebral artery appears hypoplastic.
The petrous, cavernous and supraclinoid segments of the internal carotid arteries bilaterally show normal signal and calibre. The visualized left anterior cerebral, 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 :
Filling defects are seen along the medial wall of the terminal right common carotid artery and the proximal left internal and external carotid arteries which most likely represent atheromatous plaques. Similar but smaller lesion is noted along the medial wall of the terminal left common carotid artery.
The vertebral arteries are unremarkable.
1. Altered signal in the periventricular white matter bilaterally, pons in the midline and in the subcortical white matter in the left temporo-parietal region most likely represent ischemic changes.
2. Lacunar infarcts in the thalami and corona radiata bilaterally.
3. Filling defects along the medial walls of the terminal right and left common carotid arteries and the proximal left internal and external carotid arteries most likely represent atheromatous plaques.