Date : 00.00.00
Name of the Patient : Abc Xyz Palmn / M / 79 yrs.
Referred by : Dr. Abc XyzParikh.
Examination : Intracranial and Neck M.R.A.
CLINICAL PROFILE :
H/O 2 episodes of syncopal attacks since 4 months.
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 small bright foci on the T2 Weighted images in the pons and the frontal deep white matter bilaterally. These lesions appear nearly isointense to normal white matter on the T1 Weighted images and most likely represent ischemic changes.
There is mild dilatation of both the lateral and third ventricles. The fourth ventricle is normal. There is slight 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 :
There is concentric narrowing of the distal cavernous and supraclinoid segments of the left internal carotid artery.
The petrous, cavernous and supraclinoid segment of the right internal carotid artery and the petrous segment of the left internal carotid artery show normal signal and calibre. The visualized 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 :
The left common carotid artery in the neck appears slightly smaller in calibre when compared to the right. A filling defect along the posterior wall of the proximal left internal carotid artery most likely is a flow related artifact. The common carotid artery bifurcations are unremarkable on either side.
There are no vessel wall irregularities or stenosis of the vessels noted.
1. Altered signal in the pons and the frontal deep white matter bilaterally most likely represent ischemic changes.
2. Mild dilatation of both the lateral and third ventricles.
3. Concentric narrowing of the distal cavernous and supraclinoid segments of the left internal carotid artery.
4. Slightly small calibre of the left common carotid artery when compared to the right, may be a normal variant.