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ke/sb/nl/rg.
Date : 00.00.0000

Name of the Patient : Abc XyzMariwlmn / M / 79 yrs.
Referred by : Dr. Abc Xyzatt.
Examination : M.R.I. of the Brain and
Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O drooping of the right eyelid since 4 days.

EXAMINATION :

M.R.I. of the brain was performed using the following parameters:

5 mm thick T1 Weighted, proton and T2 Weighted axial images.

3 mm thick T1 Weighted and STIR coronal images.

5 mm thick FLAIR coronal images.

5 mm thick T1 Weighted sagittal images.

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

OBSERVATION :

BRAIN :

There are ill-defined, hyperintense areas on the proton, T2 Weighted and Flair images in the posterior parietal periventricular white matter bilaterally (right more than left) and the fronto-parietal subcortical and deep white matter. These are iso to hypointense to the white matter on the T1 Weighted images and are ischemic in etiology.

There is mild dilatation of both the lateral ventricles. The third and the fourth ventricles are normal. There is slight prominence of the cerebral cortical sulci. The basal cisternal spaces are unremarkable. There is no shift of the midline structures.
..2/.






The optic nerves on the STIR images show normal signal intensity.

Incidental note is made of retrocerebellar arachnoid pouch.

Susceptibility artifacts are seen in the maxillary region probably due to dentures, with altered signal in the pons which is artifactual.

The visualized paranasal sinuses are unremarkable.

INTRACRANIAL MRA :

There is narrowing of the M1 and M2 segments of the right middle cerebral artery probably atherosclerotic.

The petrous, cavernous and supraclinoid segments of the internal carotid arteries bilaterally show normal signal and calibre. The visualized anterior cerebral, left 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 :

Flow attenuation is noted in the midsegment of the right internal carotid artery in the neck.

The common carotid arteries and their extracranial branches appear normal bilaterally. There are no vessel wall irregularities or stenosis of the vessels noted.

IMPRESSION :

1. Altered signal in the posterior parietal periventricular
white matter bilaterally (right more than left) and the fronto-parietal subcortical and deep white matter are ischemic in etiology.

2. Narrowing of the M1 and M2 segments of the right middle cerebral artery is probably atherosclerotic.



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