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ke/sb/nl/rg.

Name of the Patient : Abc Xyzram Salmn / M / 50 yrs.
Referred by : Dr. Abc Xyzasde.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O diminished vision on the left side since 00.00.0000.
Known hypertensive.

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 is a large hyperintense area within the splenium of the corpus callosum on the left side on the T2 Weighted images. This is hypointnese to white matter on the T1 Weighted images.

Ill-defined, hyperintense areas on the T2 Weighted images are seen in the pons, right optic radiation, left occipital, parafalcine cortex and in the periatrial deep white matter bilaterally. These are iso to hypointense to white matter on the T1 Weighted images and are probably ischemic in etiology.

Lacunar infarcts (isointense to CSF on all the pulse sequences) are seen in the lentiform nuclei and frontal deep white matter bilaterally.

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

Incidental note is made of left maxillary polyp.



INTRACRANIAL MRA :

The right vertebral artery is hypoplastic.

There is slight irregularity of the right Sylvian branches, basilar artery and the distal segments of the posterior cerebral arteries bilaterally.

The petrous, cavernous and supraclinoid segments of the internal carotid arteries bilaterally show normal signal and calibre. The visualized anterior cerebral, left middle cerebral and left vertebral artery show normal signal, calibre and wall margins. No obvious aneurysm or vascular malformation is identified.

NECK MRA :

The right vertebral artery is hypoplastic.

The common carotid arteries and their bifurcations appear normal bilaterally. There are no vessel wall irregularities or stenosis of the vessels noted.

IMPRESSION :

1. Altered signal within the splenium of the corpus callosum on the left side most probably is a recent ischemic lesion. The
possibility of demyelination is less likely.

2. Altered signal in the pons, left occipital, parafalcine cortex, right optic radiation and in the periatrial deep white matter bilaterally are probably ischemic in etiology.

3. Lacunar infarcts in the lentiform nuclei and frontal deep white matter bilaterally.

4. Slight irregularity of the right Sylvian branches, basilar artery and the distal segments of the posterior cerebral arteries bilaterally may be due to atherosclerosis.



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