ke/hs/rg.

Name of the Patient : Abc XyzPlmn / M / 49 yrs.
Referred by : Dr. Abc Xyzetty.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O gait ataxia since 15 days.
Known hypertensive/diabetic. On Rx.

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 an ill-defined, hyperintense signal on the T2 Weighted images in the pons, centrally and on either side of the midline. This lesion most likely represents an ischemic lesion.

A lacune (iso to hyperintense to CSF) is noted in the left putamen.

An intraluminal signal is noted in the right vertebral and basilar artery, which may suggest slow flow/thrombus.

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

Inflammatory changes are noted in the left maxillary antrum with a mucous retention cyst.

INTRACRANIAL MRA :

The normal flow within the distal right vertebral artery and the basilar artery is not visualized. There is reduction in the intensity of the distal portion of the left vertebral artery at its point of formation of the basilar artery.

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- 2 - Scan-00001


The cavernous and supraclinoid portion of the internal carotid artery on the left side is slightly smaller in calibre and irregular as compared to the right side. Slight irregularity of the vessel wall of the M1 segment of the left middle cerebral artery.

The A1 segment of the left anterior cerebral artery is hypoplastic.

The right internal carotid shows normal signal and calibre. The visualized right anterior cerebral, right middle cerebral 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.

IMPRESSION :

1. Altered signal in the pons, as described, most likely represents an ischemic lesion.

2. A lacune in the left putamen.

3. Non-visualization of the distal portion of the right vertebral artery and basilar artery.

4. Small calibre and irregularity of the supraclinoid and cavernous portion of the internal carotid artery on the left side.