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/052
Name of the Patient : Abc Xyzi T. Hadalmn / F / 65 yrs.
Referred by : Dr. Abc Xyzti / Dr. Abc Xyz.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O headaches, neckpain, giddiness and vomiting since 00.00.00.

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 :

There is an ill-defined hyperintense signal on the T2 Weighted images in the left cerebellar hemisphere, inferiorly. This lesion most likely represents an ischemic lesion, probably recent in the given clinical setting. Subtle hyperintense signal on the T1 Weighted images within this lesion would represent haemorrhagic component.

There are ill-defined, hyperintense areas on the T2 Weighted images in the posterior parietal periventricular white matter bilaterally which may also represent ischemic changes.

There is mild fullness of both the lateral ventricles. The 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 posterior cerebral artery appears as a continuation of a right posterior communicating artery.

There is concentric narrowing of the cavernous segment of the right internal carotid artery.



Irregularity and narrowing of the intracranial segments of the vertebral arteries bilaterally and of the proximal basilar artery is noted.

The petrous, cavernous and supraclinoid segments of the left internal carotid artery and the petrous and supraclinoid segments of the right internal carotid artery 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.

NECK MRA :

Flow related artifacts are noted at the left common carotid bifurcation.

The left vertebral artery appears slightly hypoplastic as compared to the right.

A plaque is noted along the medial wall of the distal right common carotid artery and the proximal right internal carotid artery without significant stenosis.

The right vertebral artery is unremarkable.

IMPRESSION :

1. Altered signal in the left cerebellar hemisphere, inferiorly most likely represents an haemorrhagic ischemic lesion, probably recent in the given clinical setting.

2. Altered signal in the posterior parietal periventricular white matter bilaterally may also represent ischemic changes.
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- 3 - Scan-00008/052



3. Concentric narrowing of the cavernous segment of the right internal carotid artery.

4. Irregularity and narrowing of the intracranial segments of the vertebral arteries bilaterally and of the proximal basilar artery.

5. A plaque along the medial wall of the distal right common carotid artery and the proximal right internal carotid artery without significant stenosis.


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