sb/ke/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzal lmn / M / 70 yrs.
Referred by : Dr. Abc Xyz Shah.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O 2 episodes of blackouts with slurred speech since April 0000.

EXAMINATION :

The brain was screened with 5 mm thick T2 Weighted axial images and 5 mm thick T1 Weighted sagittal images.

Intracranial and neck MRA were performed with 3D TOF and 2D TOF sequences, respectively.

OBSERVATION :

There are ill-defined, hyperintense areas on the proton, T2 Weighted and FLAIR images in the posterior parietal periventricular white matter bilaterally, subcortical white matter in the right fronto-temporal region and in the left insular cortex. These lesions most likely represent ischemic changes.

There is mild fullness of both the lateral ventricles.
The third and the fourth ventricles are normal. There is slight prominence of the cerebral cortical sulci and the basal cisternal spaces bilaterally. There is no shift of the midline structures.

Inflammatory changes are noted in the maxillary sinuses bilaterally and in the left mastoid air cells.

Incidentally noted is an empty sella.






INTRACRANIAL MRA :

The right vertebral artery appears hypoplastic. The left posterior cerebral artery appears as a continuation of the left posterior communicating artery from the left internal carotid artery.

The petrous, cavernous and supraclinoid segments of the internal carotid arteries bilaterally show normal signal and calibre. The visualized anterior cerebral, middle cerebral, basilar, left vertebral and right 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.

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. Altered signal in the posterior parietal periventricular white matter bilaterally, subcortical white matter in the right fronto-temporal region and in the left insular cortex most likely represent ischemic changes.

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