ke/sb/nl/rg.
/84 Date : 00.00.00

Name of the Patient : Abc Xyzs Slmn / M / 80 yrs.
Referred by : Dr. Abc Xyzmpat.
Examination : M.R.I. of the Brain and
Intracranial and Neck M.R.A.

CLINICAL PROFILE :

H/O left sided weakness with slurred speech since 1 day.
Past H/O multiple CVA in 0000.
Known hypertensive/diabetic.

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 on the proton, T2 Weighted and FLAIR images in the periventricular deep white matter bilaterally. These are iso to hypointense to normal white matter on the T1 Weighted images and are suggestive of areas of ischemia/infarction. Similar but punctate areas are noted in the pons.

There is moderate dilatation of both the lateral and third ventricles. The fourth ventricle is normal. Prominence of the cerebral cortical sulci and cerebellar folia is noted.

The basal cisternal spaces and the Sylvian fissures are also prominent. There is no shift of the midline structures.



The lens are not visualized in both the globes, the result of cataract surgery.

INTRACRANIAL MRA :

Tortuosity 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 :

There is a concentric narrowing of the left internal carotid artery about 2 cms distal to the bifurcation. This narrowing extends for about 6 mms and could be due to atherosclerosis.

The common carotid arteries and their extracranial branches appear normal bilaterally.

IMPRESSION :

1. Altered signal in the periventricular deep white matter bilaterally and in the pons are suggestive of areas of ischemia/infarction.

2. A concentric narrowing of the left internal carotid artery approximately 2 cms distal to the bifurcation with the narrowing extending for 6 mms could be due to atherosclerosis.

3. Cerebral and cerebellar atrophy.