sb/ke/rg/nl
/31 Date : 00.00.00

Name of the Patient : Abc Xyzchalmn / M / 67 yrs.
Referred by : Dr. Abc Xyzah / Dr. Abc Xyzmpat.
Examination : M.R.I. of the Brain and
Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O gait ataxia, speech disturbances and memory impairment.
Known hypertensive.

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 and Fast Scan (T2 *) coronal images.
Intracranial and neck MRA were performed with 3D TOF and 2D TOF sequences, respectively.

OBSERVATION :

BRAIN :

Lacunar infarcts are noted in the pons, periatrial regions bilaterally, bilateral lentiform nuclei and thalami and in the corona radiata and centrum semiovale bilaterally.

There are ill-defined, hyperintense areas on the proton, T2 Weighted and FLAIR images in the periventricular white matter bilaterally and in the bilateral centrum semiovale. These lesions appear hypointense to normal white matter on the T1 Weighted images. Volume loss is noted in the right high frontal region with an area of cystic encephalomalacia in that region, probably the sequelae of a previous vascular insult.

There is mild dilatation of both the lateral, third and the fourth ventricles. There is prominence of the cerebral cortical sulci, cerebellar folia and the basal cisternal spaces bilaterally. There is no shift of the midline structures.
..2/.





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INTRACRANIAL MRA :

There is slight narrowing of the distal segment of the left vertebral artery and the distal segments of the middle cerebral artery bilaterally.

The petrous, cavernous and supraclinoid segments of the internal carotid arteries bilaterally show normal signal and calibre. The visualized anterior 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 in the neck appears slightly smaller in diameter as compared to the right.

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. Lacunar infarcts in the pons, periatrial regions bilaterally, bilateral lentiform nuclei and thalami and in the corona radiata and centrum semiovale bilaterally.

2. Altered signal in the periventricular white matter bilaterally and in the bilateral centrum semiovale represents ischemic changes.

3. Volume loss in the right high frontal region with an area of cystic encephalomalacia in that region, probably the sequelae of a previous vascular insult.

4. Slight narrowing of the distal segment of the left vertebral artery and the distal segments of the middle cerebral artery bilaterally, may be atherosclerotic in etiology.