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Name of the Patient : Abc Xyz Klmn / M / 70 yrs.
Referred by : Dr. Abc Xyzbar.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O right facial weakness and also of the RUE since 00.00.00.

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 wedge-shaped hypointense area in the right temporo-parieto-occipital region on the T1 Weighted images. This is seen to turn hyperintense on the T2 Weighted images and represents an old infarct.

A lacunar infarct (iso to hyperintense to CSF) is seen in the anterior limb of the right internal capsule extending into the right corona radiata and head of the right caudate nucleus.

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

Incidental note is made of a giant cisterna magna.

INTRACRANIAL MRA :

The right vertebral artery is hypoplastic.
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- 2 - Scan-00007/00009


The petrous, cavernous and supraclinoid segments of the internal carotid arteries bilaterally show normal signal and calibre. The visualized anterior cerebral, middle cerebral, basilar, left 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 in the neck also appears 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 in the right temporo-parieto-occipital region
and which represents an old infarct.

2. A lacunar infarct in the anterior limb of the right internal capsule extending into the right corona radiata and head of the right caudate nucleus.

3. Hypoplastic right vertebral artery.