Name of the Patient : Abc Xyz Salmn / F / 39 yrs.
Referred by : Dr. Abc Xyzmpat.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O right sided weakness since 00.00.0000.

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 an area of hyperintensity on the T2 Weighted images within the thalamus on the left side. This most likely represents a recent area of ischemia/infarction.

An area of hyperintensity on the T2 Weighted images is seen within the putamen and external capsular region, extending into the corona radiata on the left side and is most likely ischemic in etiology.

Foci with similar signal characteristics are noted within the frontal white matter bilaterally and are most likely ischemic in etiology.

There is mild prominence of the cerebral cortical sulci bilaterally.

There is ectasia of the vertebro-basilar system with indentation upon the pons.

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


INTRACRANIAL MRA :

The left vertebral artery is hypoplastic. The right vertebral artery is slightly hypertrophied and ectatic.

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

NECK MRA :

The left vertebral artery in the neck is also hypoplastic.

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

IMPRESSION :

The MRA features are suggestive of :

1. Altered signal within the thalamus on the left side most likely represents a recent area of ischemia/infarction.

2. Areas of altered signal within the putamen and external capsular region, extending into the corona radiata on the left side is most likely ischemic in etiology.

3. Foci of altered signal within the frontal white matter bilaterally are most likely ischemic in etiology.

4. Hypoplastic left vertebral artery with an ectatic vertebro-basilar system.

No other significant abnormality is detected on the intracranial and neck MRA on this study.