ke/sbnl/rg.

Name of the Patient : Abc Xyzal Mallmn / M / 35 yrs.
Referred by : Dr. Abc Xyzidhungat.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O loss of vision of the left eye since 1 month.

EXAMINATION :

The brain was screened with 5 mm thick T2 Weighted axial images and 5 mm thick T1 Weighted sagittal images.

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

OBSERVATION :

There is no focal area of altered signal intensity within the brain parenchyma.

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

INTRACRANIAL MRA :

There is non-visualization of the intracranial portion of the internal carotid artery on the left side and very faint visualization of the petrous and cavernous portion of the right internal carotid artery. There is paucity of the Sylvian branches of the right middle cerebral artery. Flow signal is seen in the left middle cerebral artery and both anterior cerebral arteries.

The vertebro-basilar system is ectatic with slightly hypertrophied posterior cerebral arteries bilaterally and the left posterior communicating artery.



NECK MRA :

There is very faint visualization of the right internal carotid artery from the level of its bifurcation with narrowing of the same. The left internal carotid artery is not well-visualized in the neck.

The common carotid arteries appear normal bilaterally.

The vertebral arteries are hypertrophied and tortuous, bilaterally.

IMPRESSION :

1. Non visualization of the intracranial portion of the internal carotid artery on the left side and very faint visualization of the petrous and cavernous portion of the right internal carotid artery.

2. Paucity of the Sylvian branches of the right middle cerebral artery.

3. Ectatic vertebro-basilar system, intracranially, with slightly hypertrophid posterior cerebral arteries and left posterior communicating artery.

4. Faint visualization of the right internal carotid artery from the level of its bifurcation in the neck.

5. Hypertrophied and tortuous vertebral arteries in the neck.

An aorto-arteritis should be ruled out.