sb/hs/rg/
Date : 00.00.00

Name of the Patient : Abc Xylmn / M / 82 yrs.
Referred by : Dr. Abc Xyzhimani.
Examination : M.R.I. of the Brain and
Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O Parkinsonism since 4 years.

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 (iso to hyperintense to CSF) are noted in the thalamus, 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 subcortical and deep white matter in the fronto-parietal regions bilaterally. These lesions appear hypointense to normal white matter on the T1 Weighted images and most likely represent ischemic changes.

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 and basal cisternal spaces bilaterally. There is no shift of the midline structures.
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INTRACRANIAL MRA :

The left vertebral artery appears hypoplastic when compared to the right.

The petrous, cavernous and supraclinoid segments of the internal carotid arteries bilaterally show normal signal and calibre. The visualized anterior cerebral, middle cerebral, basilar 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 also appears hypoplastic when 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 thalamus, corona radiata and centrum semiovale bilaterally.

2. Altered signal in the periventricular white matter bilaterally and in the subcortical and deep white matter in the fronto-parietal regions bilaterally most likely represent ischemic changes.

3. No significant abnormality is detected on the intracranial and neck MRA on this study.