Name of the Patient : Abc Xyz Jalmn / M / 45 yrs.
Referred by : Dr. Abc Xyzgaonkar.
Examination : Intracranial and Neck M.R.A.
CLINICAL PROFILE :
C/O paresthesias on the right side of the body with slurred speech since 00.00.0000.
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 are hyperintense areas on the T2 Weighted images in the pons and periventricular white matter. These are isointnese to white matter on the T1 Weighted images and are most likely ischemic in etiology.
Lacunar infarcts (isointense to CSF on all the pulse sequences) are seen in the right cerebellar hemisphere, pons and right thalamus.
A transverse hypointense signal is seen within the pons on the right side on the T2 Weighted images (se/im:102/8). It is hypointense on the T1 Weighted images. This may represent paramagnetic substances (?? hemosiderin).
There is fullness of both the lateral and third ventricles. The fourth ventricle is normal. There is slight prominence of the cerebral cortical sulci.
The basal cisternal spaces are unremarkable. There is no shift of the midline structures.
Incidental note is made of a large retrocerebellar arachnoid pouch.
INTRACRANIAL MRA :
The petrous, cavernous and supraclinoid segments of the internal carotid arteries bilaterally show normal signal and calibre. The visualized anterior cerebral, 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 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 pons and periventricular white matter is most likely ischemic in etiology.
2. Lacunar infarcts in the right cerebellar hemisphere, pons and right thalamus.
3. Cerebral atrophy.
4. No significant abnormality is detected on the intracranial and neck MRA on this study.