Name of the Patient : Abc XyzMarflmn / M / 61 yrs.
Referred by : Dr. Abc Xyzdar.
Examination : Intracranial and Neck M.R.A.
CLINICAL PROFILE :
H/O fall with mild headaches.
The brain was screened with 5 mm thick T2 Weighted axial images, 5 mm thick Flair and Fast Scan (T2 *) coronal images.
Intracranial and neck MRA were performed with 3D TOF and 2D TOF sequences, respectively.
There are small bright foci on the T2 Weighted and Flair images in the deep white matter in the right posterior-parietal, high parietal region and in the left frontal region, which most likely represent ischemic changes.
Symmetric, focal hypointense signal on the Fast Scan (T2 *) images in the globus pallidi bilaterally most likely represent basal ganglia calcification.
Both the lateral, third and the fourth ventricles are normal. The basal cisternal spaces are unremarkable. There is no shift of the midline structures.
Incidentally noted is a lipoma in the subgaleal soft tissues in the left frontal region.
Inflammatory changes are seen in the ethmoidal air cells and frontal sinus on the right side.
INTRACRANIAL MRA :
The A1 segment of the right anterior cerebral artery appears hypoplastic.
The right posterior cerebral artery is slightly smaller in calibre and irregular in outline probably atherosclerotic.
The petrous, cavernous and supraclinoid segments of the internal carotid arteries bilaterally show normal signal and calibre. The visualized left anterior cerebral, 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 common carotid arteries and their extracranial branches appear normal bilaterally. There are no vessel wall irregularities or stenosis of the vessels noted.
1. Altered signal in the deep white matter in the right posterior-parietal and high parietal regions and in the left frontal region, most likely represents ischemic changes.
2. Symmetric, focal altered signal in the globus pallidi bilaterally most likely represents basal ganglia calcification.
3. A lipoma in the subgaleal soft tissues in the left frontal region.
4. Slight narrowing and irregularity of the right posterior cerebral artery probably atherosclerotic in etiology.