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Name of the Patient : Abc Xyztrao Glmn / M / 61 yrs.
Referred by : Dr. Abc Xyzatil.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O weakness of the LUE (3 episodes) on 00.00.0000 from which patient has recovered.
Now C/O tingling in BUE and BLE.

EXAMINATION :

The brain was screened with 5 mm thick T2 Weighted axial and FLAIR coronal images.

Intracranial and neck MRA were performed with 3D TOF and 2D TOF sequences, respectively.

OBSERVATION :

There is an ill-defined, hyperintense signal on the T2 Weighted and FLAIR images in the genu of the corpus callosum, extending into the frontal deep white matter bilaterally. This lesion appears hypointense on the T1 Weighted images and most likely represent an old ischemic lesion.

Lacunar infarcts (iso to hyperintense to CSF) are noted in the lentiform nucleus, bilaterally.

Both the lateral, third and the fourth ventricles are normal.
There is slight 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 :

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



The petrous, cavernous and supraclinoid segments of the internal carotid arteries bilaterally show normal signal and calibre. The visualized right anterior cerebral, 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 :

There is significant concentric narrowing with attenuated flow signal in the terminal left common carotid artery, including the origins of the left internal and external carotid arteries.

The right vertebral artery in the neck is also hypoplastic.

The right common carotid artery and its bifurcation and the left vertebral artery are unremarkable.

IMPRESSION :

1. An old ischemic lesion in the genu of the corpus callosum, extending into the frontal deep white matter bilaterally.

2. Lacunar infarcts in the lentiform nucleus, bilaterally.

3. Hypoplastic A1 segment of the left anterior cerebral artery and the right vertebral artery.

4. Significant concentric narrowing with attenuated flow signal in the terminal left common carotid artery, including the origins of the left internal and external carotid arteries.



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