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sb/hs/rg/nl
/401
Name of the Patient : Abc Xyzakala S. Patalmn / F / 40 yrs.
Referred by : Dr. Abc Xyzlal.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O weakness of the right half of the body on 00.00.0000 and visual loss 2 days later.

EXAMINATION :

The brain was screened with 5 mm thick T2 Weighted axial and coronal images.

Intracranial and neck MRA were performed with 3D TOF and 2D TOF sequences, respectively.

OBSERVATION :

There are small hyperintense areas on the T2 Weighted images in the left fronto-parietal white matter in the watershed zone of the left anterior and middle cerebral arteries. These lesions appear hypointense on the T1 Weighted images and represent ischemic lesions.

There is mild prominence of the cerebral cortical sulci and cerebellar folia bilaterally.

Both the lateral, third and the fourth ventricles are normal. The basal cisternal spaces are unremarkable. There is no shift of the midline structures.

The lumen of the intracranial segment of the left internal carotid artery appears slightly narrow when compared to the right.

INTRACRANIAL MRA :

The intracranial segment of the left internal carotid artery and the left middle cerebral artery appear smaller in calibre with attenuated flow signal. Similar features are noted in the right posterior cerebral artery.
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- 2 - Scan-00009/401


The petrous, cavernous and supraclinoid segments of the right internal carotid artery show normal signal and calibre. The visualized anterior cerebral, right middle cerebral, basilar, vertebral and left posterior cerebral arteries also show normal signal, calibre and wall margins. No obvious aneurysm or vascular malformation is identified.

NECK MRA :

The right common carotid artery and its bifurcation are unremarkable. The right common carotid artery and its bifurcation is slightly more proximal, than normal.

The vertebral arteries are unremarkable on either side.

The left common carotid artery is not well-visualized proximally. There is faint visualization of the left internal carotid artery in the neck. The left external carotid artery and its branches are not well-identified.

IMPRESSION :

1. Areas of ischemia/infarction in the watershed zone between left middle cerebral artery and left anterior cerebral artery in the left fronto-parietal lobes.

2. Decrease in calibre of the left internal carotid artery and left middle cerebral artery with attenuated flow signal.

3. The left common carotid artery in the neck is not visualized.

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