Name of the Patient : Abc XyzVaglmn / M / 66 yrs.
Referred by : Dr. Abc Xyzah.
Examination : Intracranial and Neck M.R.A.
CLINICAL PROFILE :
Known hypertensive with headaches, ? seizures and giddiness.
Past H/O CVA in April 0000.
The brain was screened with 5 mm thick T2 Weighted axial images and 5 mm thick T1 Weighted sagittal images.
Intracranial and neck MRA were performed with 3D TOF and 2D TOF sequences, respectively.
There is a subtle hypointense signal on the T2 Weighted images in the subcortical and deep white matter in the left posterior temporal region. This represents residual hemosiderin due to previous intracerebral hematoma (scan 102.12).
There are ill-defined, hyperintense areas on the T2 Weighted images in the posterior parietal periventricular white matter bilaterally and in bilateral centrum semiovale. These most likely represent ischemic changes.
Lacunar infarcts are noted in the right periatrial region and in the left posterior parietal deep white matter.
There is mild fullness of both the lateral ventricles. The third and the fourth ventricles are normal. There is slight 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 middle ear cavities bilaterally.
INTRACRANIAL MRA :
The petrous, cavernous and supraclinoid segments of the internal carotid arteries bilaterally show normal signal and calibre. The visualized anterior cerebral, middle cerebral, basilar, vertebral and posterior cerebral arteries also show normal signal, calibre and wall margins. No obvious aneurysm or vascular malformation is identified.
NECK MRA :
Flow related artifacts are noted at the common carotid bifurcations.
The common carotid arteries and their extracranial branches appear normal bilaterally. There are no vessel wall irregularities or stenosis of the vessels noted.
The cervical spine was screened with 5 mm thick T1 Weighted sagittal images. A focal syrinx (isointense to CSF) is noted at the C2 vertebral level. Degenerative changes are noted in the mid-cervical region.
1. Altered signal in the subcortical and deep white matter in the left posterior temporal region represent residual hemosiderin due to previous intracerebral hematoma.
2. Areas of altered signal in the posterior parietal periventricular white matter bilaterally and in bilateral centrum semiovale most likely represent ischemic changes.
3. Lacunar infarcts in the right periatrial region and in the left posterior parietal deep white matter.
- 3 - Scan-00005
4. No significant abnormality is detected on the intracranial and neck MRA on this study.
5. A focal syrinx in the cervical spinal cord at the C2 vertebral level.
As compared to the previous brain MRI dated 00.00.00, there is residual hemosiderin in place of the previous intracerebral hematoma.
The focal syrinx at C2 is unchanged from the previous cervical spine study dated 00.00.00.