Date : 00.00.00
Name of the Patient : Abc Xyzi lmn / F / 86 yrs.
Referred by : Dr. Abc Xyz Mehta / Dr. Abc Xyzmpat.
Examination : Intracranial and Neck M.R.A.
CLINICAL PROFILE :
H/O sudden onset of jerky movements of BLE with loss of consciousness since 2 am of 00.00.00.
H/O left hemiparesis.
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.
There is an ill-defined, hyperintense signal on the T2 Weighted images along the cortex in the right temporo-parieto-occipital region. This lesion most likely represents a recent ischemic lesion (scan 102.11).
There are ill-defined hyperintense areas on the T2 Weighted images in the periventricular white matter bilaterally, in the subcortical white matter in the fronto-parietal regions bilaterally, pons, thalamus and in the lentiform nuclei bilaterally.
There is mild dilatation of both the lateral and third ventricles. The fourth ventricle is normal.
The basal cisternal spaces are unremarkable. There is no shift of the midline structures.
INTRACRANIAL MRA :
There is concentric narrowing of the cavernous segment of the left internal carotid artery.
The posterior cerebral arteries are faintly visualized on either side.
The petrous, cavernous and supraclinoid segments of the right internal carotid artery and the petrous and supraclinoid segment of the left internal carotid artery show normal signal and calibre. The visualized anterior cerebral, middle cerebral, basilar, 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.
1. Altered signal along the cortex in the right occipito- temporo-parietal region most likely represent a recent ischemic lesion.
2. Altered signal in the periventricular white matter bilaterally, in the subcortical white matter in the fronto-parietal regions bilaterally, pons, thalamus and in the lentiform nuclei bilaterally most likely represents ischemic changes.
- 3 - Scan-00001
3. Mild age related dilatation of both the lateral and third ventricles.
4. Concentric narrowing of the cavernous segment of the left internal carotid artery.
As compared to the previous MRI (study no:00009) dated 00.00.00, the lesion in the right temporo-parieto-occipital region is a new lesion.