Name of the Patient : Abc Xyzwar Plmn / M / 63 yrs.
Referred by : Dr. Abc Xyzah.
Examination : Intracranial and Neck M.R.A.
CLINICAL PROFILE :
C/O seizure disorder.
C/O left sided hemiparesis on 00.00.0000.
The brain was screened with 5 mm thick T2 Weighted axial images,
5 mm thick Gradient coronal images and 5 mm thick T1 Weighted sagittal images.
Intracranial and neck MRA were performed with 3D TOF and 2D TOF sequences, respectively.
There is thickening of the gyri in the right fronto-parietal region with effacement of the adjacent cerebral cortical sulci.
These are hypointense to normal grey matter on the T1 Weighted images and are seen to turn hyperintense on the T2 Weighted images.
There is mild prominence of the cerebral cortical sulci and cerebellar folia bilaterally. Also seen is mild fullness of the third and both the lateral ventricles. The fourth ventricle is 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 is hypoplastic. The left vertebral artery is also hypoplastic.
There is slight narrowing of the supraclinoid portion of the left internal carotid artery. Also seen is slight narrowing, vessel wall irregularity and flow signal attenuation of the left middle cerebral artery.
The petrous, cavernous and supraclinoid segments of the right internal carotid artery and petrous and cavernous segments of the left internal carotid artery show normal signal and calibre. The visualized right anterior cerebral, right middle cerebral, basilar, right vertebral and posterior cerebral arteries also show normal signal, calibre and wall margins. No obvious aneurysm or vascular malformation is identified.
NECK MRA :
Neck images show slight patient motion.
The left vertebral artery is hypoplastic.
The common carotid arteries and their extracranial branches appear normal bilaterally. There are no vessel wall irregularities or stenosis of the vessels noted.
1. Altered signal in the right fronto-parietal region most likely represents an infarct.
2. Slight narrowing of the supraclinoid portion of the left internal carotid artery.
3. Slight narrowing, vessel wall irregularity and flow signal attenuation of the left middle cerebral artery.