sb/bv/rg.
/80 Date : 00.00.00

Name of the Patient : Abc Xyzlmn / M / 76 yrs.
Referred by : Dr. Abc XyzVirani.
Examination : M.R.I. of the Brain and
Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O weakness of the left hand since the morning of 00.00.00.
H/O antero-lateral myocardial infarction 1 year ago.

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 :

Lacunar infarcts are noted in the lentiform nuclei bilaterally and in the right centrum semiovale.

There are ill-defined hyperintense areas on the proton, T2 Weighted and FLAIR images in the posterior parietal and right frontal periventricular white matter. These lesions appear iso to hypointense to normal white matter on the T1 Weighted images.

There is mild dilatation of both the lateral and the third ventricles. The fourth ventricle is normal. There is prominence of the cerebral cortical sulci, cerebellar folia and the basal cisternal spaces bilateraly. There is no shift of the midline structures.

Inflammtory changes are noted in the maxillary sinuses bilaterally.
..2/.




Probable intraoccular lens implant is noted in the right eye.

INTRACRANIAL MRA :

The right vertebral artery appears hypoplastic.

There is concentric narrowing of the distal cavernous segment of the left internal carotid artery.

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

NECK MRA :

The right vertebral artery in the neck appears hypoplastic.

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

The left lobe of the thyroid gland appears slightly larger than the right.

IMPRESSION :

1. Lacunar infarcts in the lentiform nuclei bilaterally and in the right centrum semiovale.

2. Altered signal in the posterior parietal and right frontal periventricular white matter most likely represent ischemic changes.

3. Mild cerebral cortical and cerebellar atrophy.

4. Hypoplastic right vertebral artery.

5. Concentric narrowing of the distal cavernous segment of the left internal carotid artery.