hs/ke/nl/nl
/550 Date : 00.00.00

Name of the Patient : Abc Xyza Kuplmn / F / 52 yrs.
Referred by : Dr. Abc Xyzchale.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O weakness of BUE and BLE at 8.00 pm on 00.00.00 from which patient recovered within an hour.
Now C/O backache.
Known hypertensive/diabetic.

EXAMINATION :

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

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

The cervical spine was screened with 4 mm thick T2 Weighted sagittal images and 5 mm thick T1 Weighted and Fast Scan (T2 *) axial images. The dorsal spine was screened with 4 mm thick T2 Weighted sagittal images.

OBSERVATION :

There are small bright areas on the T2 Weighted images within the white matter in the fronto-parietal lobes and the periatrial white matter bilaterally and these are most likely ischemic in etiology.

There is prominence of the cerebral cortical sulci and cerebellar folia bilaterally. There is mild fullness of the fourth and both the lateral ventricles.

The third ventricle is normal. The basal cisternal spaces are unremarkable. There is no shift of the midline structures.







INTRACRANIAL MRA :

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 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.

There is reversal of the normal cervical lordotic curve and the cervical intervertebral discs show loss of water content. A postero-central disc herniation is seen to compress upon the spinal cord at the C4-C5 level. There is evidence of a space-occupying lesion within the posterior epidural space (more to the right) over the C5 to the C7 level. This is hyperintense to normal muscle on the T1 Weighted and Fast Scan (T2 *) images (? sequestered disc ? granulation tissue). This lesion is seen to indent the posterior aspect of the cord. A right paracentral disc protrusion is seen at the C5-C6 level and a postero-central disc protrusion is noted at the C3-C4 level. The C3-C4 to the C6-C7 joints of Luschka show mild degenerative changes.

There appears to be a D2-D3 block vertebra.
..3/.















- 3 - Scan-00007/550



IMPRESSION :

The MRA features are suggestive of :

1. Areas of altered signal within the white matter in the fronto-parietal lobes and the periatrial white matter bilaterally and these are most likely ischemic in etiology.

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

3. A postero-central disc herniation at the C4-C5 level.

4. A space-occupying lesion within the posterior epidural space (more to the right) over the C5 to the C7 level and this may represent sequestered disc/granulation tissue.