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Name of the Patient : Abc Xyzai Salulmn / F / 60 yrs.
Referred by : Dr. Abc Xyzah.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O involuntary movements of the RUE.
Known hypertensive/diabetic.

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 :

Areas of hyperintensity on the T2 Weighted images are noted within the corona radiata, centrum semiovale and periventricular white matter bilaterally. These are most likely ischemic in etiology. A smaller hyperintense area on the T2 Weighted images is seen within the pons.

There is fullness of the third and both the lateral ventricles. There is prominence of the cerebral cortical sulci bilaterally.
The fourth ventricle is normal. The basal cisternal spaces are unremarkable. There is no shift of the midline structures.

INTRACRANIAL MRA :

There is slight narrowing of a short segment of the mid-portion of the M1 segment of the right middle cerebral artery and of the left middle cerebral artery at its origin.

The left posterior cerebral artery appears to be a continuation of the left communicating artery.

The right vertebral artery is hypoplastic.


The petrous, cavernous and supraclinoid segments of the internal carotid arteries bilaterally show normal signal and calibre. The visualized anterior cerebral, basilar, left 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. The right vertebral artery is hypoplastic.

IMPRESSION :

The MRA features are suggestive of :

1. Areas of altered signal intensity within the corona radiata, centrum semiovale and periventricular white matter bilaterally and pons are most likely ischemic in etiology.

2. Slight narrowing of a short segment of the mid-portion of the M1 segment of the right middle cerebral artery and of the left middle cerebral artery at its origin.



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