Name of the Patient : Abc Xyzi lmn / M / 55 yrs.
Referred by : Dr. Abc Xyzpadia.
Examination : Intracranial and Neck M.R.A.
CLINICAL PROFILE :
C/O weakness on the right side of body.
C/O speech disturbance.
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.
There is a large, hypointense area on the T1 Weighted images in the pons anteriorly and on the left side. This is seen to turn hyperintense on the T2 Weighted images.
Subtle hyperintense areas are seen in the frontal and parietal and periventricular deep white matter on the T2 Weighted images which are probably ischemic in etiology.
There is slight fullness of both the lateral ventricles. There is mild prominence of the cerberal cortical sulci.
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 posterior cerebral artery on the right side is not visualized. The left posterior cerebral artery is irregular and appears to be a continuation of the left posterior communicating artery. The basilar artery is smaller in calibre.
The intracranial portion of the vertebral arteries bilaterally also appears small and irregular.
The petrous, cavernous and supraclinoid segments of the internal carotid arteries bilaterally show normal signal and calibre. The visualized anterior cerebral and middle 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.
1. A large area of altered signal in the pons anteriorly and on the left side is most likely ischemic in etiology.
2. Altered signal in the frontal and parietal and periventricular deep white matter is probably ischemic in etiology.
3. Non-visualization of the posterior cerebral artery on the right side.
4. Smaller calibre and irregularity of the intracranial portion of the vertebral arteries bilaterally and basilar artery.
5. Irregularity of the left posterior cerebral artery which appears to be a continuation of the left posterior communicating artery.