hs/ke/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzo L. Jlmn / M / 65 yrs.
Referred by : Dr. Abc Xyzatil / Dr. Abc Xyztrak.
Examination : M.R.I. of the Brain and
Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O tingling in the left palm and the LLE since 15 days.
Known hypertensive. On Rx.

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 coronal images.

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

OBSERVATION :

BRAIN :

There are areas of hyperintensity on the proton, T2 Weighted and FLAIR images within the periventricular white matter and fronto-parietal white matter bilaterally. These are iso to hypointense to normal white matter on the T1 Weighted images and are most likely ischemic in etiology.

Lacunar infarcts (iso to hyperintense to CSF) are seen within the upper pons on the right side, genu of the corpus callosum on the right side and within the thalamus, lentiform nuclei and periatrial white matter bilaterally.

There is mild prominence of the basal cisternal spaces, cerebral cortical sulci and cerebellar folia bilaterally. Also seen is mild fullness of both the lateral and the third ventricles. The fourth ventricle is normal. There is no shift of the midline structures.
..2/.





INTRACRANIAL MRA :

There is slight attenuation of the distal portion of the right posterior cerebral 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, vertebral and the left posterior cerebral artery also shows 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 :

The MRI/MRA features are suggestive of :

1. Altered signal within the periventricular white matter and fronto-parietal white matter bilaterally is most likely ischemic in etiology.

2. Lacunar infarcts within the upper pons on the right side, genu of the corpus callosum on the right side and within the thalamus, lentiform nuclei and periatrial white matter bilaterally.

3. Slight attenuation of the distal portion of the right posterior cerebral artery.