sb/hs/rg.
Name of the Patient : Abc Xyza lmn / F / 75 yrs.
Referred by : Dr. Abc Xyzmat.
Examination : Intracranial and Neck M.R.A.
CLINICAL PROFILE :
H/O sudden onset of slurred speech for 2 hours on 00.00.0000.
EXAMINATION :
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.
OBSERVATION :
There are small bright foci on the T2 Weighted images in the subcortical white matter in the frontal regions bilaterally. These lesions most likely represent ischemic changes.
There is mild to moderate dilatation of both the lateral ventricles. There is mild fullness of the third ventricle. The fourth ventricle is normal. There is slight prominence of the cerebral cortical sulci bilaterally. The basal cisternal spaces are unremarkable. There is no shift of the midline structures.
INTRACRANIAL MRA :
The A1 segment of the left anterior cerebral artery appears hypoplastic.
The intracranial segment of the left internal carotid artery appears slightly smaller in calibre when compared to the right. Slight irregularity of the M1 segment of the left middle cerebral artery is noted.
Scan-00006
The petrous, cavernous and supraclinoid segments of the right internal carotid artery shows normal signal and calibre. The visualized right anterior cerebral, right 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 :
The left common carotid artery and left internal carotid artery in the neck also appear slightly smaller in calibre when compared to the right. Tortuosity of the proximal left internal and external carotid artery is noted.
Slight flattening of the common carotid bulb is noted bilaterally.
The vertebral arteries are unremarkable on either side.
IMPRESSION :
1. Small bright foci on the T2 Weighted images in the subcortical white matter in the frontal regions bilaterally most likely represent ischemic changes.
2. Hypoplastic A1 segment of the left anterior cerebral artery.
3. Slightly smaller calibre of the left internal carotid artery and the left common carotid artery when compared to the right may either be a normal variant or may be due to atherosclerotic changes.
4. Slight irregularity of the M1 segment of the left middle cerebral artery may be due to atherosclerotic changes.
5. Mild to moderate dilatation of both the lateral ventricles.