sb/hs/nl
Date : 00.00.00

Name of the Patient : Abc Xyzslmn / M / 72 yrs.
Referred by : Dr. Abc Xyzmpat.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O right sided weakness since 1 day.

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, just to the left of the midline. This lesion most likely represents an ischemic lesion, probably recent, in the given clinical setting.

Ill-defined, hyperintense signal on the T2 Weighted images in the periventricular white matter bilaterally and in bilateral centrum semiovale also represents white matter ischemic changes.

Lacunar infarcts are noted in the right lentiform nucleus and right thalamus.

There is mild dilatation of both the lateral and third ventricles. The fourth ventricle is normal. There is prominence of the cerebral cortical sulci, cerebellar folia and the basal cisternal spaces bilaterally. There is no shift of the midline structures.

Incidentally noted is an empty sella.



INTRACRANIAL MRA :

There is hypoplasia of the right vertebral artery. There is slight irregularity and narrowing of both the vertebral arteries, distally, the proximal basilar artery and the cavernous segment of the right internal carotid artery. The posterior cerewbral arteries are slightly attenuated.

The vertebral arteries are ectatic.

The petrous, cavernous and supraclinoid segments of the left internal carotid artery and the petrous and supraclinoid segment of the right internal carotid artery show normal signal and calibre. The visualized anterior cerebral, middle cerebral arteries also show normal signal, calibre and wall margins. No obvious aneurysm or vascular malformation is identified.

NECK MRA :

The visualized common carotid arteries and their bifurcations are unremarkable. The visualized left vertebral artery appears normal.

The visualized right vertebral artery is hypoplastic. Slight narrowing of the right vertebral artery at the junction of its proximal and middle third segments in the neck is noted.

IMPRESSION :

1. Altered signal in the pons, just to the left of the midline most likely represents an ischemic lesion, probably recent, in the given clinical setting.

2. Altered signal in the periventricular white matter bilaterally and in bilateral centrum semiovale also represents white matter ischemic changes.
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3. Lacunar infarcts in the right lentiform nucleus and right thalamus.

4. Irregularity and narrowing of the distal vertebral arteries, the proximal basilar artery and the cavernous segment of the right internal carotid artery may represent atherosclerotic changes.