sb/ke/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzas Buddhlmn / M / 80 yrs.
Referred by : Dr. Abc Xyz Sampat.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O inability to swallow since 3 days.
Known hypertensive.

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 :

Ill-defined hyperintense areas on the T2 Weighted images are noted in the periventricular white matter bilaterally, and in the medulla, pons, thalami and lentiform nuclei and in the corona radiata and centrum semiovale bilaterally. These most likely represent ischemic changes.

Lacunar infarcts are noted in the thalami and lentiform nuclei bilaterally.

There is an approximately 1.8 x 1.3 cms diameter sized well marginated, hyperintense lesion on all the pulse sequences in the right cerebellar hemisphere, postero-lateral to the fourth ventricle. A peripheral hypointense rim, more pronounced on the T2 Weighted images is noted around this lesion.

There is mild to moderate dilatation of the ventricular system.

There is prominence of the cerebral cortical sulci, cerebellar folia and basal cisternal spaces bilaterally.

There is no shift of the midline structures.

Inflammatory changes are noted in the maxillary antra bilaterally.

INTRACRANIAL MRA :

Tortuousity of the intracranial vessels is noted.

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.

IMPRESSION :

1. Altered signal in the periventricular white matter bilaterally, and in the medulla, pons, thalami and lentiform nuclei and in the corona radiata and centrum semiovale bilaterally most likely represent ischemic changes.

2. Lacunar infarcts in the thalami and lentiform nuclei bilaterally.

3. An approximately 1.8 x 1.3 cms diameter sized well marginated, lesion in the right cerebellar hemisphere, postero-lateral to the fourth ventricle represents a late subacute hematoma.

4. Mild to moderate dilatation of the ventricular system with cerebral cortical and cerebellar atrophy.

5. Tortuousity of the intracranial vessels. No other significant abnormality is detected on the intracranial and neck MRA on this study.