Date : 00.00.00
Name of the Patient : Abc Xyzchand N. lmn / M / 67 yrs.
Referred by : Dr. Abc Xyzna / Dr. Abc Xyz Punjabi.
Examination : M.R.I. of the Brain and
Intracranial and Neck M.R.A.
CLINICAL PROFILE :
H/O fall at 4.00 am of 00.00.00, with weakness of left half of body and mild dysarthria which has improved since then.
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.
5 mm thick T1 Weighted sagittal images.
Intracranial and neck MRA were performed with 3D TOF and 2D TOF sequences, respectively.
There are hyperintense areas on the proton, T2 Weighted and FLAIR images in the posterior parietal deep white matter. These are isointense to white matter on the T1 Weighted images and are suggestive of areas of ischemia/infarction.
Prominent perivascular space is seen in the right lentiform nucleus (se/im 105/11).
There is slight fullness of both the lateral, third and the fourth ventricles with mild prominence of the cerebral cortical sulci and the cerebellar folia bilaterally. The basal cisternal spaces are unremarkable. There is no shift of the midline structures.
Incidental note is made of retrocerebellar arachnoid pouch/mega cisterna magna.
INTRACRANIAL MRA :
There is a cut-off at the distal segment of the right middle cerebral artery with non-visualization of the Sylvian branches of the right middle cerebral artery.
The posterior cerebral artery on the right side appears as continuation of the posterior communicating artery. The right posterior cerebral artery and the left middle cerebral artery appear irregular.
The petrous, cavernous and supraclinoid segments of the internal carotid arteries bilaterally show normal signal and calibre. The visualized anterior cerebral, basilar, vertebral and left posterior cerebral 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.
1. Areas of ischemia/infarction in the posterior parietal deep white matter bilaterally.
2. Cut-off of the distal segment of the right middle cerebral artery with non-visualization of the Sylvian branches may suggest embolic episode.
3. Slight irregularity of the right posterior cerebral artery and left middle cerebral artery may be due to atherosclerosis.