/71 Date : 00.00.00
Name of the Patient : Abc Xyzshna Kalmn / M / 58 yrs.
Referred by : Dr. Abc Xyzzare.
Examination : Intracranial and Neck M.R.A.
CLINICAL PROFILE :
C/O right sided hemiplegia with slurred speech since 15 days.
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.
Areas which are iso to hyperintense to CSF on all the pulse sequences are seen within the left lentiform nucleus and left corona radiata and would represent old infarcts.
Hyperintense areas on the T2 Weighted images are noted in the periventricular white matter and white matter in the fronto-parietal lobes bilaterally and these are most likely ischemic in etiology.
There is mild dilatation of the third and both the lateral ventricles. There is prominence of the cerebral cortical sulci bilaterally.
The fourth ventricle is normal. The basal cisternal spaces are unremarkable. There is no shift of the midline structures.
Inflammatory changes are seen in the mastoid air cells on the right side.
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INTRACRANIAL and Neck MRA :
The right vertebral artery is smaller in calibre as compared to the opposite side and shows flow signal attenuation.
There is irregularity of the vessel wall of the posterior cerebral arteries bilaterally and the basilar artery.
Also seen is vessel wall irregularity and narrowing of the lumen of the cavernous component of the both the internal carotid arteries and the proximal aspect of the M1 segment of both the middle cerebral arteries.
The A1 segment of the right anterior cerebral artery is hypoplastic.
The petrous and supraclinoid segments of the internal carotid arteries bilaterally show normal signal and calibre. The visualized anterior cerebral and left vertebral arteries also show normal signal, calibre and wall margins. No obvious aneurysm or vascular malformation is identified.
The common carotid arteries and their extracranial branches appear normal bilaterally.
The MRA features are suggestive of :
1. Old infarcts within the left lentiform nucleus and left corona radiata.
2. Areas of altered signal within the periventricular white matter and white matter in the fronto-parietal lobes bilaterally and these are most likely ischemic in etiology.
- 3 - Scan-00009/71
3. The right vertebral artery is smaller in calibre as compared to the opposite side (? hypoplastic, ? atherosclerotic changes).
4. Vessel wall irregularity of the posterior cerebral arteries bilaterally and basilar artery.
5. Vessel wall irregularity and decreased lumen of the cavernous component of both the internal carotid arteries and the proximal aspect of the M1 segment of both the middle cerebral arteries.