sb/ke/nl/rg
Date : 00.00.00

Name of the Patient : Abc Xyzl Ganlmn / M / 78 yrs.
Referred by : Dr. Abc Xyzagwati / Dr. Abc Xyztrak.
Examination : M.R.I. of the Brain and
Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O weakness of the LLE since 00.00.00 and LUE since 00.00.00.
C/O increased frequency of micturition.
Known hypertensive.

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.

5 mm thick T1 Weighted sagittal images.

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

OBSERVATION :

BRAIN :

There are ill-defined, hyperintense areas on the proton, T2 Weighted and FLAIR images in the posterior parietal periventricular white matter bilaterally and in the corona radiata and centrum semiovale bilaterally. These lesions appear iso to hypointense to normal white matter on the T1 Weighted images and most likely represent ischemic changes. Similar signal intensity lesions are noted in the right lentiform nucleus, posteriorly and in the right corona radiata, posteriorly which may be recent ischemic lesions in the given clinical setting. No obvious haemorrhage is identified on this study.



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

INTRACRANIAL MRA :

There is irregularity and narrowing of the petrous and cavernous segments of the left internal carotid artery. Slight irregularity of the left vertebral artery, basilar artery in its mid segment, P2 segment of the left posterior cerebral artery and ? irregularity of the right middle cerebral artery, distally, is noted.

The A1 segment of the left anterior cerebral artery appears hypoplastic. The right posterior cerebral artery appears as a continuation of the right posterior communicating artery.

The petrous, cavernous and supraclinoid segments of the right internal carotid artery and supraclinoid segment of the left internal carotid artery show normal signal and calibre. The visualized right anterior cerebral, left middle cerebral, right vertebral and right posterior cerebral arteries also show normal signal, calibre and wall margins. No obvious aneurysm or vascular malformation is identified.

NECK MRA :

There is tortuousity of the right common carotid artery and the vertebral arteries bilaterally.

An atherosclerotic plaque is noted along the posterior wall of the left internal carotid artery at its origin.
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- 3 - Scan-00000



The common carotid arteries and their bifurcations are unremarkable.

IMPRESSION :

1. Altered signal in the posterior parietal periventricular white matter bilaterally and in the corona radiata and centrum semiovale bilaterally most likely represent ischemic changes.

2. Altered signal in the right lentiform nucleus, posteriorly and in the right corona radiata, posteriorly may be recent ischemic lesions in the given clinical setting.

3. Irregularity and narrowing of the petrous and cavernous segments of the left internal carotid artery with slight irregularity of the left vertebral artery, basilar artery in its mid segment, P2 segment of the left posterior cerebral artery and ? irregularity of the right middle cerebral artery, distally, may be atherosclerotic in etiology.

4. An atherosclerotic plaque along the posterior wall of the right internal carotid artery just distal at its origin.

As compared to the previous MRI dated 00.00.00, the lesions in the right lentiform nucleus, posteriorly, right corona radiata posteriorly are new lesions.