hs/sb/nl/rg.
Date : 00.00.00

Name of the Patient : Abc XyzBagayalmn / M / 42 yrs.
Referred by : Dr. Abc Xyzmpat.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O left sided weakness.

EXAMINATION :

The brain was screened with 5 mm thick FLAIR coronal images.

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

OBSERVATION :

There is an ill-defined, hyperintense signal on the FLAIR images in the right paraatrial region, right frontal periventricular and deep white matter, right corona radiata, right high parietal, parafalcine cortex and in the splenium of the corpus callosum on the right. These lesions most likely represent ischemic lesions.

There is a wedge shaped CSF signal intensity lesion in the left cerebellar hemisphere, inferiorly. Perilesional hyperintense signal on the FLAIR images may represent gliotic changes.

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

INTRACRANIAL MRA :

There is narrowing of the supraclinoid portion of the right internal carotid artery and the proximal, M1 segment of the right middle cerebral artery.

The right posterior comunicating artery is seen to be prominent.

The left vertebral artery is hypoplastic.


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

NECK MRA :

The left vertebral artery is hypoplastic. The lower segment of the left vertebral artery is not well visualized.

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 right paraatrial region, right frontal periventricular and deep white matter, right corona radiata, right high parietal parafalcine cortex, in the splenium of the corpus callosum on the right are most likely ischemic lesions.

2. Areas of cystic encephalomalacia in the left cerebellar hemisphere, inferiorly, is most likely the sequelae of a previous vascular insult.

3. Narrowing of the supraclinoid portion of the right internal carotid artery and the proximal M1 segment of the right middle cerebral artery.

4. Hypoplastic left vertebral artery. The lower segment of the left vertebral artery is not well visualized.