Date : 00.00.0000
Name of the Patient : Abc Xyzhai P. Plmn / M / 55 yrs.
Referred by : Dr. Abc Xyzla.
Examination : M.R.I. of the Brain and
Intracranial and Neck M.R.A.
CLINICAL PROFILE :
C/O right hemiparesis with dysphagia since 00.00.0000.
H/O similar episode on 00.00.0000.
M.R.I. of the brain was performed using the following parameters:
5 mm thick T1 Weighted, proton and T2 Weighted axial images.
5 mm thick FLAIR and Fast Scan (T2 *) coronal images.
Intracranial and neck MRA were performed with 3D TOF and 2D TOF sequences, respectively.
There is an ill-defined, hyperintense signal on the proton, T2 Weighted and FLAIR images along the left temporo-parieto-frontal cortex. This lesion appears iso to hypointense to normal gray matter on the T1 Weighted images. Resultant sulcal space effacement is noted in the left temporo-parieto-frontal region.
There are ill-defined, hyperintense areas on the proton, T2 Weighted and FLAIR images in the pons, periventricular white matter, corona radiata and centrum semiovale bilaterally. These lesions also appear hypointense on the T1 Weighted images.
Lacunar infarcts are noted in the deep frontal parafalcine regions bilaterally, just superior to the body of the corpus callosum with resultant slight thinning of the corpus callosum in that region.
A Choroid fissure cyst (?? lacunar infarct) is noted on the left side (Scan 102.11).
Both the lateral, third and the fourth ventricles are normal. The basal cisternal spaces are unremarkable. There is no shift of the midline structures.
There is no obvious evidence of haemorrhage on this study.
INTRACRANIAL MRA :
The vertebro-basilar system is ectatic.
The Sylvian branches of the left middle cerebral artery appear attenuated and are not well-identified. The Sylvian branches of the right middle cerebral artery and the right posterior cerebral artery appears irregular.
The petrous, cavernous and supraclinoid segments of the internal carotid arteries bilaterally show normal signal and calibre. The visualized anterior cerebral, basilar, vertebral and left posterior cerebral arteries also show normal signal, calibre and wall margins. No obvious aneurysm or vascular malformation is identified.
NECK MRA :
Motion artifacts are noted.
The common carotid arteries and their bifurcation and the vertebral arteries appear normal bilaterally. Slight tortuousity of the internal and external carotid arteries, bilaterally is noted.
1. Altered signal along the left temporo-parieto-frontal cortex most likely represents a recent ischemic lesion.
- 3 - Scan-00006
2. Altered signal in the pons, periventricular white matter, corona radiata and centrum semiovale bilaterally most ikely represents ischemic lesions.
3. Lacunar infarcts in the deep frontal parafalcine
4. Attenuated Sylvian branches of the left middle cerebral artery may be due to atherosclerotic changes.
5. Irregularity of the Sylvian branches of the right middle cerebral artery and the right posterior cerebral artery may be due to atherosclerotic changes.