Name of the Patient : Abc Xyzlmn / F / 65 yrs.
Referred by : Dr. Abc Xyz/ Dr. Abc Xyzka.
Examination : Intracranial and Neck M.R.A.
CLINICAL PROFILE :
C/O numbness of the RUE and RLE 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 ill-defined hyperintense areas on the T2 Weighted images in the subcortical white matter in the fronto-parietal regions bilaterally which most likely represents ischemic changes.
There is mild fullness of both the lateral ventricles. There is slight prominence of the cerebral cortical sulci and cerebellar folia bilaterally.
The third and the fourth ventricles are normal. 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 and the right vertebral artery are hypoplastic. Ectasia of the vertebro-basilar system is noted.
There is concentric narrowing of the petrous and cavernous segments of the left internal carotid artery.
Slight irregularity of the distal segment of the right middle cerebral artery is also noted.
The petrous, cavernous and supraclinoid segments of the right internal carotid artery show normal signal and calibre. The visualized right anterior cerebral, left 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 also appears hypoplastic. slight flattening of the left carotid bulb is noted.
The right common carotid artery and its bifurcation and the left vertebral artery are unremarkable.
The left common carotid artery and its extracranial branches appear normal bilaterally. There are no vessel wall irregularities or stenosis of the vessels noted.
1. Altered signal in the subcortical white matter in the fronto-parietal regions bilaterally most likely represent ischemic changes.
2. Hypoplastic A1 segment of the left anterior cerebral artery and the right vertebral artery.
3. Concentric narrowing of the petrous and cavernous segments of the left internal carotid artery, slight irregularity of the distal segment of the right middle cerebral artery and flattening of the left carotid bulb may be due to atherosclerotic changes.