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sb/hs/rg.

Name of the Patient : Abc XyzPoonawlmn / F / 59 yrs.
Referred by : Dr. Abc Xyzlkaka.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O right hemiparesis since 00.00.0000.
Known diabetic.

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 small bright focus on the T2 Weighted images in the deep white matter in the right parietal region which most likely represents an ischemic lesion.

There is slight prominence of the cerebral cortical sulci and cerebellar folia 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.

INTRACRANIAL MRA :

There is concentric narrowing of the cavernous and supraclinoid segments of the left internal carotid artery and the supraclinoid segment of the right internal carotid artery. Slight irregularity and narrowing of the distal segment of the right middle cerebral artery and the M1 segment of the left middle cerebral artery and some of its Sylvian branches is noted. The posterior cerebral arteries also appear slightly attenuated.

The A1 segment of the left anterior cerebral artery is hypoplastic.
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The petrous segments of the internal carotid arteries bilaterally show normal signal and calibre. The visualized right anterior cerebral, basilar, vertebral arteries also show normal signal, calibre and wall margins. No obvious aneurysm or vascular malformation is identified.

NECK MRA :

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

The right common carotid artery and the right internal carotid artery are unremarkable. The right external carotid artery is not visualized and is most likely occluded at its origin.

IMPRESSION :

1. Altered signal in the deep white matter in the right parietal region most likely represents an ischemic lesion.

2. Concentric narrowing of the cavernous and supraclinoid segments of the left internal carotid artery and the supraclinoid segment of the right internal carotid artery with irregularity and narrowing of the middle cerebral arteries bilaterally and attenuated flow signal in the posterior cerebral arteries as described is most likely due to atherosclerotic changes.

3. Occlusion of the right external carotid artery at its origin.



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