Name of the Patient : Abc Xyz Kalmn / M / 21 yrs.
Referred by : Dr. Abc Xyzasde.
Examination : Intracranial and Neck M.R.A.
CLINICAL PROFILE :
C/O left sided hemiparesis since 1 day.
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.
SOME IMAGES SHOW PATIENT MOTION.
There is a hyperintense signal on the T2 Weighted images along the cortex of the right temporal lobe, right putamen extending into the right corona radiata. This is hypointense to the white matter on the T1 Weighted images and represents a fresh infarct. There is slight mass effect with indentation upon the body of the right lateral ventricle.
The left 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 Sylvian branches of the right middle cerebral artery appear attenuated and are displaced slightly supero-medially.
The petrous, cavernous and supraclinoid segments of the internal carotid arteries bilaterally show normal signal and calibre. The visualized anterior cerebral, left middle cerebral, basilar, vertebral and posterior cerebral arteries also show normal signal, calibre and wall margins. No obvious aneurysm or vascular malformation is identified.
NECK MRA :
The right vertebral artery is slightly smaller in calibre as compared to the left.
There is slight irregularity and narrowing of the proximal segment of the right internal carotid artery, just distal to the right common carotid bifurcation, over a 1.5 cms segment. Flow related artifact is noted, distal to the narrowed segment. The left common carotid artery and its bifurcation are unremarkable.
1. Recent infarcts along the cortex of the right temporal lobe, right putamen extending into the right corona radiata.
2. Attenuated Sylvian branches of the right middle cerebral artery.
3. Irregularity and narrowing of the proximal right internal carotid artery as described.