sb/ke/nl/rg.
Date : 00.00.00
Name of the Patient : Abc Xyzal Milmn / M / 56 yrs.
Referred by : Dr. Abc Xyzidhungat.
Examination : Intracranial and Neck M.R.A.
CLINICAL PROFILE :
C/O inability to talk for an hour on 00.00.00.
C/O decreased vision bilaterally since 4-5 years.
Known hypertensive/diabetic.
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 :
An old infarct which is hypointense on the T1 Weighted images and hyperintense on the T2 Weighted images is noted in the right lentiform nucleus, extending into the right corona radiata.
Ill-defined hyperintense signal is noted on the T2 Weighted images in the pons, to the right of the midline. This most likely represents an ischemic lesion.
There is mild fullness of both the lateral and third ventricles. The fourth ventricle is normal. There is prominence of the cerebral cortical sulci and cerebellar folia bilaterally.
The basal cisternal spaces are unremarkable. There is no shift of the midline structures.
Inflammatory changes are noted in the left maxillary antrum.
INTRACRANIAL MRA :
There is hypoplasia of the A1 segment of the right anterior cerebral artery.
Mild concentric narrowing of the cavernous segment of the right internal carotid artery is noted.
The petrous, cavernous and supraclinoid segments of the left internal carotid artery show normal signal and calibre. The visualized left 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.
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. An old infarct in the right lentiform nucleus, extending into the right corona radiata.
2. Altered signal in the pons, to the right of the midline, most likely represents an ischemic lesion.
3. Mild concentric narrowing of the cavernous segment of the right internal carotid artery may be atherosclerotic in etiology.