sb/ke/nl/rg.
/8 Date : 00.00.00

Name of the Patient : Abc Xyzari A. Salmn / M / 73 yrs.
Referred by : Dr. Abc Xyzrdiwala.
Examination : M.R.I. of the Brain and
Intracranial and Neck M.R.A.

CLINICAL PROFILE :

H/O sudden fall with right sided weakness and loss of speech at 9.30 am on 00.00.00.

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 :

There is an ill-defined, hyperintense signal on the proton, T2 Weighted and FLAIR images in the head of the left caudate nucleus and left lentiform nucleus. These lesions appear hypointense to normal white matter on the T1 Weighted images and most likely represent a recent ischemic lesions.

Small bright foci on the proton, T2 Weighted and FLAIR images in the posterior parietal periventricular white matter bilaterally and in the frontal and parietal deep white matter and centrum semiovale also represents ischemic lesions.

Both the lateral, third and the fourth ventricles are normal. There is slight prominence of the cerebral cortical sulci and cerebellar folia bilaterally. The basal cisternal spaces are unremarkable. There is no shift of the midline structures.
..2/.




- 2 - Scan-00006/8



There is no evidence of hemorrhage on this study.

INTRACRANIAL MRA :

The left middle cerebral artery and its branches are not visualized. A proximal 7.0 mms stump of the left MCA is identified.

The right posterior cerebral artery appears slightly hypoplastic.

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, vertebral and left 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. Altered signal in the head of the left caudate nucleus and left lentiform nucleus most likely represent recent ischemic lesions.

2. Small bright foci on the proton, T2 Weighted and FLAIR images in the posterior parietal periventricular white matter bilaterally and in the frontal and parietal deep white matter and centrum semiovale also represent ischemic lesions.

3. A proximal 7.0 mms stump of the left middle cerebral artery is identified. The distal left middle cerebral artery and its branches are not well visualized on this study and may suggest left MCA thrombosis.