sb/ke/rg/nl
Date : 00.00.00
Name of the Patient : Abc XyzNalmn / M / 75 yrs.
Referred by : Dr. Abc Xyzibhakar.
Examination : M.R.I. of the Brain and
Intracranial and Neck M.R.A.
CLINICAL PROFILE :
C/O giddiness with blurred vision since 7-8 days.
EXAMINATION :
M.R.I. of the brain was performed using the following parameters:
5 mm thick T1 Weighted, proton and T2 Weighted axial images.
5 mm thick FLAIR coronal images.
3 mm thick STIR coronal images through the optic nerves.
Intracranial and neck MRA were performed with 3D TOF and 2D TOF sequences, respectively.
OBSERVATION :
BRAIN :
There is an ill-defined, hyperintense signal on the proton, T2 Weighted and FLAIR images in the posterior parietal periventricular white matter bilaterally which is nearly isointense to normal white matter on the T1 Weighted images.
Small bright foci on the T2 Weighted and FLAIR images are noted in the subcortical white matter in the left frontal region.
Prominent perivascular spaces are seen in the posterior parietal regions bilaterally.
There is mild dilatation of both the lateral and the third ventricles. The fourth ventricle is normal. There is slight prominence of the cerebral cortical sulci bilaterally. The basal cisternal spaces are unremarkable. There is no shift of the midline structures.
..2/.
>
The optic nerves show normal signal on the STIR images bilaterally.
INTRACRANIAL MRA :
There is slight concentric narrowing of the cavernous segments of the internal carotid arteries bilaterally.
The petrous and supraclinoid segments of the internal carotid arteries bilaterally 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 :
There is slight irregularity of the proximal segment of the right internal carotid artery just distal to its bifurcation.
A probable small, atherosclerotic plaque is noted along the postero-lateral margin of the left internal carotid artery just distal to its bifurcation.
The common carotid arteries and their extracranial branches appear normal bilaterally.
IMPRESSION :
1. Altered signal in the posterior parietal periventricular white matter bilaterally most likely represents ischemic changes with small ischemic foci in the subcortical white matter in the left frontal region.
2. Slight concentric narrowing of the cavernous segments of the internal carotid arteries bilaterally and irregularity of the proximal segment of the right internal carotid artery and a probable small plaque along the postero-lateral margin of the left internal carotid artery most likely suggest atherosclerotic changes.