ke/hs/nl/nl
/573 Date : 00.00.00

Name of the Patient : Abc Xyz Chlmn / M / 52 yrs.
Referred by : Dr. Abc XyzMalgaonkar.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O right sided hemiparesis with slurred speech since 15 days.
Known hypertensive.

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.

OBSERVATION :

There is a hypointense area on the T1 Weighted images in the left frontal deep white matter. This is seen to turn hyperintense on the T2 Weighted images and represents an area of ischemia/ infarction. Similar area is also noted in the left lentiform nucleus posteriorly and in the left paraatrial deep matter and these are also most likely ischemic in etiology.

A lacunar infarct is noted in the left cerebellar hemisphere.

There is prominence of the cerebellar folia and cerebral cortical sulci bilaterally.

Both the lateral, third and the fourth ventricles are normal. The basal cisternal spaces are unremarkable. There is no shift of the midline structures.

Note is made of a retrocerebellar arachnoid pouch.

INTRACRANIAL MRA :

The mid portion of the left middle cerebral artery for a distance of approximately 4.0 mms. is not visualized. There appears to be slight paucity of vessels in the left Sylvian area.
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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 posterior cerebral arteries also show normal signal, calibre and wall margins. No obvious aneurysm or vascular malformation is identified.

NECK MRA :

The left vertebral artery is seen to arise from the aortic arch.

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. Areas of ischemia/infarction in the left frontal deep white matter, in the left lentiform nucleus posteriorly and in the left paraatrial deep matter.

2. A lacunar infarct in the left cerebellar hemisphere.

3. Non-visualization of the mid portion of the left middle cerebral artery for a distance of approximately 4.0 mms.