hs/ke/rg.
Date : 00.00.00

Name of the Patient : Abc XyzV. Blmn / M / 72 yrs.
Referred by : Dr. Abc Xyzah.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O giddiness with blackouts and fall with LOC for 2 minutes (6 episodes in last 10 years). Visual loss on the left side in 0000.
Known hypertensive. On Rx.

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 :

Hyperintense areas on the T2 Weighted images are seen within the periventricular white matter, centrum semiovale and corona radiata bilaterally and these are most likely ischemic in etiology.

Smaller areas with similar signal characteristics are seen within the pons, thalamus and lentiform nuclei bilaterally.

There is fullness of the third and both the lateral ventricles. There is mild prominence of the cerebral cortical sulci and cerebellar folia bilaterally. The fourth ventricle is normal. There is no shift of the midline structures.

INTRACRANIAL & NECK MRA :

The left internal carotid artery is not visualized in its entirety from its origin in the neck.

The right posterior communicating and anterior communicating arteries are prominent.


The petrous, cavernous and supraclinoid segments of the right internal carotid artery 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.

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

IMPRESSION :

The MRA features are suggestive of :

1. Areas of altered signal within the periventricular white matter, centrum semiovale and corona radiata bilaterally,
pons, thalamus and lentiform nuclei bilaterally are
most likely ischemic in etiology.

2. Non visualization of the left internal carotid artery.