ke/sb/nl/rg.
Date : 00.00.00

Name of the Patient : Abc XyzKaplmn / M / 67 yrs.
Referred by : Dr. Abc Xyz Sampat.
Examination : M.R.I. of the Brain and
Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O diminished vision in the right eye with pain and heaviness of the head since 3-4 months.
Known hypertensive/diabetic.
Known C/O epilepsy.

EXAMINATION :

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.

Intracranial and neck MRA were performed with 3D TOF and 2D TOF sequences, respectively.

OBSERVATION :

BRAIN :

There are ill-defined, hyperintense areas in the periatrial deep white matter on the T2 Weighted and FLAIR images. These are isointense to normal white matter on the T1 Weighted images and are suggestive of areas of ischemia/infarction.

Small bright foci on the proton, T2 Weighted and FLAIR images are seen in the left corona radiata and centrum semiovale.

There is mild dilatation of both the lateral ventricles. The frontal horn of the right lateral ventricle appears small ? a normal variant. The third and the fourth ventricles are normal. There is slight prominence of the cerebellar folia bilaterally. The basal cisternal spaces are unremarkable. There is no shift of the midline structures.
..2/.






INTRACRANIAL MRA :

The right anterior communicating artery is hypoplastic. The right posterior cerebral artery arises from the right internal carotid 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 and vertebral arteries also show normal signal, calibre and wall margins. No obvious aneurysm or vascular malformation is identified.

NECK MRA :

There is concentric narrowing of the right carotid bulb and the proximal right and internal and external carotid arteries for approximately 1.2 cms. This could be due to atherosclerosis. A post-stenotic jet is noted in the proximal right internal cerebral artery.

The left common cartoid artery and its bifurcation and the vertebral arteries are unremarkable.

IMPRESSION :

1. Areas of altered signal in the periatrial deep white matter are suggestive of areas of ischemia/infarction.

2. Small bright foci in the left corona radiata and centrum semiovale may also represent ischemic lesions.

3. Hypoplastic right anterior communicating artery.

4. Concentric narrowing of the right carotid bulb and the proximal internal and external carotid arteries could be due to atherosclerosis.