sb/ke/nl/rg.
Name of the Patient : Abc Xyzunder Kariwlmn / M / 71 yrs.
Referred by : Dr. Abc Xyzpta.
Examination : Intracranial and Neck M.R.A.
CLINICAL PROFILE :
C/O numbness over the LLE since 1 day.
Known hypertensive.
EXAMINATION :
The brain was screened with 5 mm thick T2 Weighted axial images and 5 mm thick T1 Weighted sagittal images.
Intracranial and neck MRA were performed with 3D TOF and 2D TOF sequences, respectively.
OBSERVATION :
There is seen a well marginated, approximately 1.5 x 3.0 x 2.0 cms sized well marginated relatively hypointense lesion on the T2 Weighted images in the left parieto-occipital, parafalcine region. This lesion appears slightly hyperintense to normal parenchyma on the T1 Weighted images. There is mild perilesional edema with sulcal space effacement and minimal indentation on the splenium of the corpus callosum on the left.
There are ill-defined, hyperintense areas on the T2 Weighted images in the posterior parietal deep white matter bilaterally and in the subcortical white matter in the fronto-parietal regions bilaterally. These lesions most likely represent ischemic changes.
There is mild fullness of both the lateral ventricles.
The third and the fourth ventricles are normal. There is slight prominence of the cerebral cortical sulci and cerebellar folia bilaterally. The basal cisternal spaces are unremarkable. There is no shift of the midline structures.
Incidentally noted is an empty sella.
INTRACRANIAL MRA :
The petrous, cavernous and supraclinoid segments of the internal carotid arteries bilaterally show normal signal and calibre. The visualized anterior cerebral, 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 :
There is a plaque along the medial wall of the terminal right common carotid artery minimally extending into the proximal right internal carotid artery. A similar lesion is also noted along the lateral wall of the distal left common carotid artery (best appreciated on the source images).
The right common carotid artery appears slightly tortuous.
The right vertebral artery is slightly hypoplastic. The left vertebral artery is unremarkable.
IMPRESSION :
1. An approximately 1.5 x 3.0 x 2.0 cms sized mass lesion in the left parieto-occipital, parafalcine region most likely represent an acute hematoma.
2. Altered signal in the posterior parietal deep white matter bilaterally and in the subcortical white matter in the fronto-parietal regions bilaterally most likely represent ischemic changes.
3. A plaque along the medial wall of the terminal right common carotid artery minimally extending into the proximal right internal carotid artery and a similar lesion along the lateral wall of the distal left common carotid artery (best appreciated on the source images).