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Name of the Patient : Abc Xyzai G. Ylmn / F / 51 yrs.
Referred by : Dr. Abc Xyzmat.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O left hemiplegia since 2 days.
H/O right hemiplegia 7-8 months ago (recovered partially).

EXAMINATION :

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.

OBSERVATION :

There are hyperintense areas on the T2 Weighted images in the pons, genu of the internal capsule on the left side, bilateral lentiform nuclei, corona radiata and centrum semiovale and periventricular white matter bilaterally. These are iso to hypointense to white matter on the T1 Weighted images and are most likely ischemic in etiology.

A hypointense area is seen in the left thalamus on the T2 Weighted images and may represent hemosiderin (probably the result of a previous bleed).

There is mild prominence of the cerebral cortical sulci.

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

Hyperintense signal is seen within the transverse and sigmoid sinus on the left side and may represent slow flow.

INTRACRANIAL MRA :

The A1 segment of the right anterior cerebral artery and right vertebral artery are hypoplastic.
..2/.



- 2 - Scan-00007


There is slight narrowing and irregularity of the petrous, cavernous and the supraclinoid segments of the internal carotid artery on the right side and is probably atherosclerotic in etiology.

Slight irregularity of the distal segment of the right posterior cerebral artery is noted.

The petrous, cavernous and supraclinoid segments of the left internal carotid artery shows normal signal and calibre. The rest of the visualized anterior cerebral, middle cerebral, basilar, vertebral and left 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 is hypoplastic.

There is narrowing and irregularity of the right internal carotid artery from its origin.

The common carotid arteries appear normal bilaterally. The left internal carotid artery is unremarkable. There are no vessel wall irregularities or stenosis of the vessels noted.

IMPRESSION :

The MRA features are suggestive of :

1. Areas of altered signal in the pons, genu of the internal capsule on the left side, bilateral lentiform nuclei, corona radiata and centrum semiovale and periventricular white matter bilaterally are most likely ischemic in etiology.
..3/.









- 3 - Scan-00007



2. Altered signal in the left thalamus may represent hemosiderin (probably the result of a previous bleed).

3. Slight narrowing and vessel wall irregularity of the right internal carotid artery is probably atherosclerotic in etiology.

4. Slight irregularity of the distal segment of the right posterior cerebral artery.



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