sb/hs/rg.
/00000 Date : 00.00.00
Name of the Patient : Abc Xyzra lmn / M / 70 yrs.
Referred by : Dr. Abc Xyzah.
Examination : Intracranial and Neck M.R.A.
CLINICAL PROFILE :
H/O deviation of mouth towards the right on the 00.00.00 for 4 hours which is recovered.
EXAMINATION :
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.
Motion artifacts are noted in some images due to involuntary jaw movements.
OBSERVATION :
A lacunar infarct (iso to hyperintense to CSF) is noted in the right thalamus.
Ill-defined, hyperintense signal on the T2 Weighted images in the posterior parietal periventricular white matter on the left, most likely represents ischemic changes.
There is mild dilatation of both the lateral and the third ventricles. The fourth ventricle is normal. There is prominence of the cerebral cortical sulci and cerebellar folia bilaterally.
The basal cisternal spaces are unremarkable. There is no shift of the midline structures.
Inflammatory changes are noted in the paranasal sinuses.
Incidentally noted is an empty sella.
INTRACRANIAL MRA :
The A1 segment of the left anterior cerebral artery appears hypoplastic.
There is flow signal attenuation within posterior cerebral arteries.
The petrous, cavernous and supraclinoid segments of the internal carotid arteries bilaterally show normal signal and calibre. The visualized right anterior cerebral, middle cerebral, basilar and vertebral arteries also show normal signal, calibre and wall margins. No obvious aneurysm or vascular malformation is identified.
NECK MRA :
The common carotid arteries and their extracranial branches appear normal bilaterally. There are no vessel wall irregularities or stenosis of the vessels noted.
IMPRESSION :
1. A lacunar infarct in the right thalamus.
2. Altered signal in the posterior parietal periventricular white matter on the left, most likely represents ischemic changes.
3. Cerebral and cerebellar atrophy.
4. Flow signal attenuation within posterior cerebral arteries.