Name of the Patient : Abc XyzKarim Islmn / M / 74 yrs.
Referred by : Dr. Abc Xyzvale.
Examination : Intracranial and Neck M.R.A.
CLINICAL PROFILE :
H/O right facial palsy with right sided weakness 12 days back which has recovered partially.
H/O similar complaints 3 months ago, on the left side.
Now C/O difficulty in swallowing and speech disturbances.
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.
Areas of hyperintensity on the T2 Weighted images are seen within the head of the caudate nucleus and the lentiform nucleus on the left side and most likely represent recent areas of ischemia/infarction.
Few hyperintense areas on the T2 Weighted images are also seen within the fronto-parietal white matter, the pons and left thalamus and these are most likely ischemic in etiology. A lacunar infarct is seen in the right lentiform nucleus.
There is prominence of the cerebral cortical sulci and cerebellar folia bilaterally. There is fullness of the third and both the lateral ventricles. The fourth ventricle is normal. The basal cisternal spaces are unremarkable. There is no shift of the midline structures.
INTRACRANIAL MRA :
The petrous, cavernous and supraclinoid segments of the internal carotid arteries bilaterally show normal signal and calibre. The visualized anterior cerebral, 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 common carotid arteries and their extracranial branches appear normal bilaterally. There are no vessel wall irregularities or stenosis of the vessels noted.
1. Areas of altered signal intensity within the head of the caudate nucleus and the lentiform nucleus on the left side most likely represent recent areas of ischemia/infarction.
2. A lacunar infarct in the right lentiform nucleus.
3. No significant abnormality is detected on the intracranial and neck MRA on this study.