sb/hs/nl/rg.
Date : 00.00.0000

Name of the Patient : Abc Xyzen Khlmn / F / 55 yrs.
Referred by : Dr. Abc XyzVaishnav.
Examination : M.R.I. of the Brain and
Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O vertigo.

EXAMINATION :

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

5 mm thick T1 Weighted, proton and T2 Weighted axial images.
5 mm thick FLAIR coronal images.
Intracranial and neck MRA were performed with 3D TOF and 2D TOF sequences, respectively.

OBSERVATION :

BRAIN :

There is an ill-defined, hyperintense signal on the proton, T2 Weighted and FLAIR images in the right lateral medulla, right inferior cerebellar peduncle and in the right middle cerebellar peduncle. This lesion appears hypointense on the T1 Weighted images. Resultant mild effacement of the fourth ventricle is noted.

Ill-defined hyperintense signal on the proton, T2 Weighted and FLAIR images is noted in the posterior parietal periventricular white matter bilaterally and which most likely represent ischemic changes.

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 and cerebellar folia bilaterally. The basal cisternal spaces are unremarkable. There is no shift of the midline structures.

Incidentally noted is retinal detachment bilaterally.
..2/.






INTRACRANIAL MRA :

The right vertebral artery, the right posterior communicating artery and the A1 segment of the right anterior cerebral artery are hypoplastic.

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, left vertebral and posterior cerebral arteries also show normal signal, calibre and wall margins. No obvious aneurysm or vascular malformation is identified.

NECK MRA :

The right vertebral artery in the neck is also hypoplastic.

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 right lateral medulla, right inferior cerebellar peduncle and in the right middle cerebellar peduncle most likely represents ischemic changes, probably recent.

2. Altered signal in the posterior parietal periventricular white matter bilaterally, most likely represents ischemic changes.

3. Except for a hypoplastic right vertebral artery, A1 segment of the right anterior cerebral artery and the right posterior communicating artery, no other significant abnormality is detected within the intracranial and neck MRA on this study.