Date : 00.00.0000
Name of the Patient : Abc Xyzlmn / M / 70 yrs.
Referred by : Dr. Abc Xyzchaporia.
Examination : M.R.I. of the Brain and
Intracranial and Neck M.R.A.
CLINICAL PROFILE :
C/O right sided weakness with slurred speech on 00.00.0000 from which patient recovered partially.
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 coronal images.
5 mm thick T1 Weighted sagittal images.
Intracranial and neck MRA were performed with 3D TOF and 2D TOF sequences, respectively.
There is an ill-defined hyperintense area on the proton, T2 Weighted and FLAIR images in the subcortical white matter in the right temporo-parietal region and in the left frontal region. This lesions appear iso to hypointense to normal white matter on the T1 Weighted images and most likely represent ischemic changes. Resultant volume loss is noted in the right temporo-parietal region with mild dilatation of the right lateral ventricle.
Lacunar infarcts are noted in the left cerebellar hemisphere, thalami bilaterally, right posterior parietal deep white matter and in the left frontal region.
There is mild to moderate dilatation of both the lateral and third ventricles. The fourth ventricle is normal. There is slight prominence of the cerebral cortical sulci and cerebellar folia and the basal cisternal spaces bilaterally. There is no shift of the midline structures.
INTRACRANIAL MRA :
There is slight concentric narrowing of the distal right vertebral artery.
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 :
There is slight flattening of the left carotid bulb.
The right common carotid artery and its bifurcation and the vertebral arteries are unremarkable on either side.
1. Altered signal in the subcortical white matter in the right temporo-parietal region and in the left frontal region most likely represent ischemic changes.
2. Lacunar infarcts in the left cerebellar hemisphere, thalami bilaterally, right posterior parietal deep white matter and in the left frontal region.
3. Slight concentric narrowing of the distal right vertebral artery and slight flattening of the left carotid bulb may be due to atherosclerotic changes.
4. Age related cerebral cortical and cerebellar atrophy.