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ke/hs/nl/rg.

Name of the Patient : Abc Xyzm Milmn / M / 38 yrs.
Referred by : Dr. Abc Xyzrani.
Examination : Intracranial MR Venogram.

CLINICAL PROFILE :

H/O right sided hemiplegia.

EXAMINATION :

The brain was screened with the help of 5 mm thick T1 Weighted sagittal images and T2 Weighted axial images.

MRV was performed using a 2D TOF technique.

OBSERVATION :

There is an ill-defined, hyperintense signal on the T2 Weighted images in the right high parietal parafalcine cortex and along the right fronto-parietal cortex. This lesion appears hypointense to normal white matter on the T1 Weighted images and represents an ischemic lesion, most likely recent, in the given clinical setting. Subtle, hypointense signal on T2 Weighted images are noted within this lesion which may represent hemoglobin breakdown products (acute blood).

A hyperintense signal on the T2 Weighted images is noted within the lumen of the right internal carotid artery and this may represent slow flow/thrombus.

There is a CSF intensity lesion on all pulse sequences in the right posterior parietal, parafalcine cortex. Perilesional white matter hyperintense signal on the T2 Weighted and FLAIR images adjacent to this may represent gliotic changes.

There is a hyperintense signal on the T2 Weighted images in the head of caudate nucleus on the left side.

A lacunar infarct is noted in the left frontal deep white matter.

Both the lateral, third and the fourth ventricles are normal. The basal cisternal spaces are unremarkable. There is no shift of the midline structures. ..2/.





INTRACRANIAL MRV :

On the MRV the visualized dural and deep venous sinuses show normal flow characteristics. No obvious venous thrombosis is evident on this scan.

The transverse and sigmoid sinuses on the left side are hypoplastic.

Inflammatory changes are noted in the right maxillary antrum.

IMPRESSION :

1. Altered signal in the right high parietal parafalcine cortex and along the right fronto-parietal cortex represents an ischemic lesion, most likely recent, in the given clinical setting.

2. Probable slow flow/thrombus within the internal carotid artery on the right side.

3. Altered signal in the right posterior parietal, parafalcine cortex represents encephalomalacic changes, most likely the sequelae of a previous vascular insult.

4. A lacunar infarct in the left frontal deep white matter.

5. Altered signal in the head of the caudate nucleus is suggestive of an ischemic lesion.

6. No significant abnormality detected on the Intracranial MR Venogram.


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