sb/ke/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzhai Chaudlmn / M / 59 yrs.
Referred by : Dr. Abc Xyz Apte.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O right sided hemiplegia 3 months back.
C/O left sided hemiplegia 1 1/2 months back with speech disturbances.
Known diabetic.

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 is an ill-defined, hyperintense signal on the T2 Weighted images in the left lentiform nucleus, left insular cortex, left corona radiata and in the left high frontal cortex. This lesion appears hypointense on the T1 Weighted images. Volume loss is noted in that region.

Similar signal intensity changes are noted in the right fronto-temporal cortex.

Hyperintense signal on the T2 Weighted images is also noted in the subcortical white matter in the frontal regions bilaterally.

There is mild dilatation of both the lateral and third ventricles. The fourth ventricle is normal. There is slight prominence of the cerebral cortical sulci and the basal cisternal spaces bilaterally. There is no shift of the midline structures.
Scan-00003


INTRACRANIAL MRA :

The A1 segment of the left anterior cerebral artery appears hypoplastic.

The left middle cerebral artery an its branches appear slightly attenuated.

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

MOTION ARTIFACTS ARE NOTED IN SOME IMAGES.

The left vertebral artery is hypoplastic.

There is concentric narrowing of the proximal 2.0 cms segment of the internal carotid arteries bilaterally, with significant stenosis. The visualized external carotid arteries and the common carotid arteries appear unremarkable.

IMPRESSION :

1. Altered signal in the left lentiform nucleus, left insular cortex, left corona radiata and in the left high frontal cortex and in the right fronto-temporal cortex represents old infarcts.
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2. Altered signal in the subcortical white matter in the frontal regions bilaterally represents ischemic changes.

3. Hypoplastic A1 segment of the left anterior cerebral artery and the left vertebral artery.

4. Attenuation of the left middle cerebral artery and its branches.

5. Concentric narrowing of the proximal 2.0 cms segment of the internal carotid arteries bilaterally, with significant stenosis.