sb/hs/rg.
Date : 00.00.00
Name of the Patient : Abc Xyz. Chaulmn / M / 47 yrs.
Referred by : Dr. Abc Xyzah.
Examination : Intracranial and Neck M.R.A.
CLINICAL PROFILE :
H/O right hemiparesis 4 months ago from which the patient recovered.
C/O momentary giddiness with blackouts since then.
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.
OBSERVATION :
A lacunar infarct (isointense to CSF on the T2 Weighted images)
is noted in the left thalamus.
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 :
The right vertebral artery is hypoplastic as compared to the left. It does not unite with the opposite vertebral artery and probably continues as the posterior inferior cerebellar artery.
The left vertebral artery is seen to continue as the basilar artery. Slight ectasia of the vertebro-basilar system is noted.
The petrous, cavernous and supraclinoid segments of the internal carotid arteries bilaterally show normal signal and calibre. The visualized anterior cerebral, middle cerebral and posterior cerebral arteries also show normal signal, calibre and wall margins. No obvious aneurysm or vascular malformation is identified.
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NECK MRA :
There is hypoplasia of the right vertebral artery as compared to the left.
A plaque is noted along the postero-lateral wall of the terminal right common carotid artery and the proximal right internal carotid artery with resultant mild narrowing of the said
vessels in that region.
Flow related artifacts are noted at the left common carotid bifurcation.
IMPRESSION :
1. A lacunar infarct in the left thalamus.
2. Changes described in the vertebro-basilar system may be a normal variant.
3. A plaque along the postero-lateral wall of the terminal right common carotid artery and the proximal right internal carotid artery.