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Name of the Patient : Abc XyzLallmn / F / 30 yrs.
Referred by : Dr. Abc Xyzgaonkar.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O weakness of the right half of the body with loss of speech since 4-5 days.

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 evidence of gyral thickening in the left fronto-temporal lobe. These are hypointense on the T1 Weighted images and turn hyperintense on the T2 Weighted images. Also seen is involvement of the left insular cortex. This lesion would most likely represent a recent area of ischemia/infarction.

Smaller areas with similar signal characteristics are noted within the white matter in the right frontal lobe/right corona radiata.

There is mild fullness of both the lateral and the third ventricles. There is mild prominence of the cerebral cortical sulci and cerebellar folia bilaterally.

There is no shift of the midline structures.

INTRACRANIAL MRA :

There is abrupt tapering of the M1 segment of the left middle cerebral artery at its mid-portion with a sliver of flow seen distally. Also seen is a paucity of the left Sylvian branch.
..2/.






- 2 - Scan-00009


The petrous, cavernous and supraclinoid segments of the internal carotid arteries bilaterally show normal signal and calibre. The visualized anterior cerebral, right 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 :

The common carotid arteries and their extracranial branches appear normal bilaterally. There are no vessel wall irregularities or stenosis of the vessels noted.

IMPRESSION :

The MRA features are suggestive of :

1. A recent area of ischemia/infarction within the left fronto-temporal lobe.

2. A smaller area of ischemia/infarction in the right frontal lobe/right corona radiata.

3. Abrupt tapering of the M1 segment of the left middle cerebral artery at its mid-portion with a sliver of flow seen distally (? due to an embolus).


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