Date : 00.00.00
Name of the Patient : Abc XyzThalmn / M / 69 yrs.
Referred by : Dr. Abc Xyzatt.
Examination : Intracranial and Neck M.R.A.
CLINICAL PROFILE :
C/O weakness of the RLE since 12.00 am of 00.00.00.
The brain was screened with 5 mm thick FLAIR axial images and 3 mm thick FLAIR coronal images.
Intracranial and neck MRA were performed with 3D TOF and 2D TOF sequences, respectively.
Focal hyperintense signal is seen on the Flair images in the left corona radiata and this may represent an area of recent ischemia/infarction. Ill-defined, hyperintense signal on the Flair images in the right posterior parietal periventricular white matter may represent ischemic changes.
Both the lateral, third and the fourth ventricles are normal. The basal cisternal spaces are unremarkable. There is no shift of the midline structures.
INTRACRANIAL MRA :
There is flow signal attenuation within the distal part of the M1 segment of the right middle cerebral artery.
Slight vessel wall irregularity of the left vertebral artery is noted. The right vertebral artery is hypoplastic.
The petrous, cavernous and supraclinoid segments of the internal carotid arteries bilaterally show normal signal and calibre. The visualized anterior cerebral, left middle cerebral, basilar and posterior cerebral arteries also show normal signal, calibre and wall margins. No obvious aneurysm or vascular malformation is identified.
NECK MRA :
The right vertebral artery in the neck is also hypoplastic.
The common carotid arteries and their extracranial branches appear normal bilaterally. There are no vessel wall irregularities or stenosis of the vessels noted.
The MRA features are suggestive of :
1. Altered signal in the left corona radiata may represent an area of recent ischemia/infarction.
2. Flow signal attenuation within the distal part of the M1 segment of the right middle cerebral artery.
3. Slight vessel wall irregularity of the left vertebral artery.
As compared to the previous MRI (Scan No.00008) dated 00.00.00, the signal change identified in the left corona radiata, is a new lesion.