hs/sb/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz K. lmn / M / 41 yrs.
Referred by : Dr. Abc Xyzrdiwalla.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O sudden onset of giddiness with gait ataxia to the right and pain in the nape of neck since 00.00.00.

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 are multiple areas of hyperintensity on the T2 Weighted images within the centre and right postero-lateral aspect of the medulla on the T2 Weighted images. These are most likely ischemic in etiology.

There is mild prominence of the cerebral cortical sulci bilaterally.

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

A short segment of the right vertebral artery is seen from its origin. The rest of the right vertebral artery does not show normal flow signal (streaky flow is seen at a few levels). A dissection of this artery should be considered.

The right posterior communicating artery is seen to be prominent.





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

The common carotid arteries and their extracranial branches appear normal bilaterally. There are no vessel wall irregularities or stenosis of the vessels noted.

The cervical spine was screened with 4 mm thick T1 Weighted sagittal images and does not reveal any significant feature of note.

IMPRESSION :

1. Areas of altered signal within the centre and right postero-lateral aspect of the medulla are ischemic in etiology.

2. A short segment of the right vertebral artery is seen from its origin with the rest of the right vertebral artery not showing normal flow signal (streaky flow at a few levels). A dissection of this artery should be considered.