Name of the Patient : Abc Xyzai Dlmn / M / 47 yrs.
Referred by : Dr. Abc Xyzed.
Examination : Intracranial and Neck M.R.A.
CLINICAL PROFILE :
H/O left hemiplegia on 00.00.00 which is recovered.
Now C/O slight slurred speech.
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 is an area of hyperintensity on the T2 Weighted images within the right lentiform nucleus. This is most likely ischemic in etiology.
A lacunar infarct (iso to hyperintense to CSF) is seen within the lentiform nucleus and corona radiata on the left side.
There is fullness of the third and both the lateral ventricles. The fourth ventricle is normal. There is mild prominence of the cerebral cortical sulci and cerebellar folia bilaterally.
The basal cisternal spaces are unremarkable. There is no shift of the midline structures.
INTRACRANIAL MRA :
There is slight flow signal attenuation within the mid portion of the right posterior cerebral artery.
There is mild vessel wall irregularity of the distal portion of the M1 segment of both middle cerebral arteries.
The petrous, cavernous and supraclinoid segments of the internal carotid arteries bilaterally show normal signal and calibre. The visualized anterior cerebral, basilar, vertebral and left posterior cerebral artery also show normal signal, calibre and wall margins. No obvious aneurysm or vascular malformation is identified.
NECK MRA :
There is a slight filling defect at the postero-lateral aspect of the distal left common carotid artery just prior to its bifurcation.
The right common carotid artery and its extracranial branches appear normal. There are no vessel wall irregularities or stenosis of the vessels noted.
1. Altered signal within the right lentiform nucleus is most likely ischemic in etiology.
2. A lacunar infarct within the lentiform nucleus and corona radiata on the left side.
3. Slight flow signal attenuation within the mid portion of the right posterior cerebral artery.
4. Mild vessel wall irregularity of the distal portion of the M1 segment of both middle cerebral arteries.
5. A slight filling defect at the postero-lateral aspect of the distal left common carotid artery just prior to its bifurcation and this may represent an atherosclerotic plaque.