sb/hs/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzi R. lmn / M / 72 yrs.
Referred by : Dr. Abc Xyzpadia.
Examination : M.R.I. of the Brain and
Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O giddiness with mild gait imbalance since 3 weeks.
Known hypertensive.

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.

MR Cisternogram was obtained in the coronal plane.

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

OBSERVATION :

BRAIN :

There are small bright foci on the proton, T2 Weighted and FLAIR images in the left lentiform nucleus and in the left posterior parietal deep white matter. These lesions appear hypointense to normal white matter on the T1 Weighted images and most likely represent ischemic lesions.

There is mild dilatation of both the lateral and third ventricles. The fourth ventricle is normal. There is prominence of the cerebral cortical sulci and cerebellar folia bilaterally.

The basal cisternal spaces are unremarkable. There is no shift of the midline structures.
..2/.






INTRACRANIAL MRA :

The right vertebral artery is hypoplastic. The right posterior cerebral artery arises directly from the right internal carotid artery. Slight tortuousity of the intracranial vessels is noted. There is slight irregularity of the anterior cerebral arteries and the distal segment of the left middle cerebral artery.

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

NECK MRA :

The right vertebral artery in the neck also appears hypoplastic.

Tortuousity of the internal and external carotid arteries bilaterally and the left vertebral artery in the neck is noted.

There are no vessel wall irregularities or stenosis of the vessels noted.

IMPRESSION :

1. Altered signal in the left lentiform nucleus and in the left posterior parietal deep white matter most likely represent ischemic lesions.

2. The right posterior cerebral artery is seen to arise directly from the right internal carotid artery.

3. Slight irregularity of the anterior cerebral arteries and the distal segment of the left middle cerebral artery may represent atherosclerotic changes.