sb/ke/nl/rg.
Name of the Patient : Abc Xyzam Salmn / M / 52 yrs.
Referred by : Dr. Abc Xyztrak.
Examination : Intracranial and Neck M.R.A.
CLINICAL PROFILE :
Past H/O vertigo.
C/O left sided weakness 2 days back with heaviness of tongue.
EXAMINATION :
The brain was screened with 5 mm thick T2 Weighted axial images and 5 mm thick FLAIR coronal images.
Intracranial and neck MRA were performed with 3D TOF and 2D TOF sequences, respectively.
OBSERVATION :
There is a hyperintense area in the right lentiform nucleus extending into the right corona radiata on the T2 Weighted and FLAIR images. This is hypointense to normal white matter on the T1 Weighted images and represents a fresh infarct.
Lacunar infarcts are seen in the pons on the left side, bilateral lentiform nuclei and right periatrial deep white matter.
Both the lateral, third and the fourth ventricles are normal. The basal cisternal spaces are unremarkable. There is no shift of the midline structures.
Inflammatory changes are noted in the right maxillary antrum.
INTRACRANIAL MRA :
There is slight irregularity and narrowing of the petrous and
cavernous segments of the internal carotid arteries bilaterally. Irregularity is also noted in the P2 segment of the left posterior cerebral artery and this is probably atherosclerotic in etiology.
The A1 segment of the left anterior cerebral artery is hypoplastic.
..2/.
The visualized right anterior cerebral, middle cerebral, basilar, vertebral and right posterior cerebral artery also show normal signal, calibre and wall margins. No obvious aneurysm or vascular malformation is identified.
NECK MRA :
There is slight flattening of the right carotid bulb with concentric narrowing of the proximal 1.5 cms of the right
internal carotid artery from the level of its bifurcation. Slight irregularity of the proximal 2.2 cms of the left internal carotid artery is also noted.
The vertebral arteries are unremarkable.
IMPRESSION :
1. A fresh infarct in the right lentiform nucleus extending into the right corona radiata, which was not seen on the previous MRI dated 00.00.0000.
2. Lacunar infarcts in the pons on the left side, bilateral lentiform nuclei and right periatrial deep white matter.
3. Slight irregularity and narrowing of the petrous and cavernous segments of the internal carotid arteries bilaterally and irregurality in the P2 segment of the left posterior cerebral artery is probably atherosclerotic in etiology.
4. Hypoplastic A1 segment of the left anterior cerebral artery.
5. Slight flattening of the right carotid bulb with concentric narrowing of the proximal 1.5 cms of the right internal carotid artery from the level of its bifurcation. Irregularity of the proximal 2.2 cms of the left internal carotid artery is also noted. These changes may also be due to atherosclerosis.