sb/ke/nl/rg.
/885 Date : 00.00.00

Name of the Patient : Abc Xyzram Tlmn / M / 50 yrs.
Referred by : Dr. Abc Xyzah.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O 3 episodes of pain in the occipital region with change in voice and giddiness for 2-3 minutes since 15 days.

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 :

There are small bright foci on the T2 Weighted images in the left centrum semiovale along the watershed zone of the left anterior and middle cerebral arteries. These most likely represent ischemic 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 concentric narrowing of the cavernous segment of the left internal carotid artery with resultant mild stenosis of the said vessel. There is however, good signal of the distal intracranial vessels on the left side.

The petrous, cavernous and supraclinoid segments of the right internal carotid artery and the petrous and supraclinoid segment of the left 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.
..2/.







NECK MRA :

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. Small bright foci on the T2 Weighted images in the left centrum semiovale along the watershed zone of the left anterior and middle cerebral arteries most likely represent ischemic changes.

2. Concentric narrowing and stenosis of the cavernous segment of the left internal carotid artery may be atherosclerotic in the etiology.