Date : 00.00.0000
Name of the Patient : Abc Xyz Kelalmn / M / 68 yrs.
Referred by : Dr. Abc Xyzstak.
Examination : M.R.I. of the Brain and
Intracranial and Neck M.R.A.
CLINICAL PROFILE :
H/O right hemiplegia 7 years back which is recovered partially.
C/O left hemiplegia since 00.00.0000.
M.R.I. of the brain was performed using the following parameters:
5 mm thick T1 Weighted, proton and T2 Weighted axial images.
5 mm thick FLAIR coronal images.
Intracranial and neck MRA were performed with 3D TOF and 2D TOF sequences, respectively.
Lacunar infarcts are noted in the left lentiform nucleus and in the left corona radiata posteriorly.
There are ill-defined hyperintense areas on the proton, T2 Weighted and FLAIR images in the periventricular white matter bilaterally and the subcortical white matter in the frontal and parietal regions bilaterally. These lesions appear iso to hypointense to normal white matter on the T1 Weighted images and most likely represents ischemic changes.
There is mild to moderate dilatation of both the lateral and the third ventricles. The fourth ventricle is normal. There is prominence of the cerebral cortical sulci, cerebellar folia and the basal cisternal spaces bilaterally. There is no shift of the midline structures.
Inflammatory changes are noted in the right maxillary antrum.
INTRACRANIAL MRA :
The intracranial segment of the right vertebral artery and the A1 segment of the right anterior cerebral artery appear hypoplastic.
The posterior cerebral arteries are the continuation of the posterior communicating arteries bilaterally.
Slight irregularity of the cavernous segment of the left internal carotid artery is noted.
The petrous, cavernous and supraclinoid segments of the right internal carotid artery and petrous and supraclinoid segment of the left internal carotid artery show normal signal and calibre. The visualized left anterior cerebral, middle 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 right vertebral artery in the neck also appear hypoplastic.
There is a plaque along the posterior wall of the distal left common carotid artery with resultant mild narrowing of the same. The right common carotid bifurcation and proximal right internal and external carotid arteries are unremarkable.
There is concentric narrowing of the proximal 1.5 cms. of the
right internal carotid artery just distal to its bifurcation.
The origin of the right external carotid artery also appears slightly narrow.
The right common carotid artery is tortuous. The left vertebral artery is unremarkable.
- 3 - Scan-00001
1. Lacunar infarcts in the left lentiform nucleus and in the left corona radiata posteriorly.
2. Altered signal in the periventricular white matter bilaterally and the subcortical white matter in the frontal and parietal regions bilaterally most likely represents ischemic changes.
3. Cerebral and cerebellar atrophy with mild dilatation of both the lateral and the third ventricles.
4. A plaque along the posterior wall of the distal left common carotid artery with resultant mild narrowing of the same.
5. Concentric narrowing of the proximal 1.5 cms. of the
right internal carotid artery just distal to its bifurcation and the origin of the right external carotid artery, probably due to atherosclerotic changes.