sb/ke/nl/rg.
/888 Date : 00.00.00

Name of the Patient : Abc Xyzam K. Thlmn / M / 63 yrs.
Referred by : Dr. Abc Xyzala.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O fluent aphasia.

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 is an ill-defined, hyperintense signal on the T2 Weighted images along the left temporo-parietal cortex and subcortical white matter. This lesion most likely represents a recent cortical infarct. Resultant effacement of the sulcal spaces is noted in the left temporo-parietal region, with minimal indentation on the left lateral ventricle.

Ill-defined, hyperintense signal on the T2 Weighted images in the posterior parietal periventricular white matter bilaterally represents old ischemic lesions.

There is mild dilatation of both the lateral and third ventricles. The fourth ventricle is normal.

The basal cisternal spaces are unremarkable. There is slight prominence of the cerebral cortical sulci and cerebellar folia bilaterally. There is no shift of the midline structures.

There is no obvious haemorrhage on this study.
Scan-00006/888



INTRACRANIAL MRA :

The vertebro-basilar system appears ectatic. Slight hypoplasia of the right vertebral artery is noted as compared to the left. The Sylvian branches of the left middle cerebral artery are slightly stretched and displaced medially, by the mass effect caused by the left temporo-parietal cortical infarct. There is irregularity and concentric narrowing of the M1 segment of the left middle cerebral artery, distally.

The petrous, cavernous and supraclinoid segments of the internal carotid arteries bilaterally show normal signal and calibre. The visualized anterior cerebral, right 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 is also hypoplastic.

There is narrowing of the origin of the right external carotid artery which however shows good distal signal. The right common carotid artery and the right internal carotid artery appear unremarkable.

The left common carotid artery and their bifurcation and the left vertebral artery also appear unremarkable.









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IMPRESSION :

A recent infarct along the left temporo-parietal cortex and subcortical white matter.

Altered signal in the posterior parietal periventricular white matter bilaterally represents old ischemic lesions.

Slightly stretched and medially displaced sylvian branches of the left middle cerebral artery by the mass effect caused by the left temporo-parietal cortical infarct. There is irregularity and concentric narrowing of the M1 segment of the left middle cerebral artery, distally.