ke/hs/nl/nl
Date : 00.00.00

Name of the Patient : Abc XyzKarguplmn / F / 70 yrs.
Referred by : Dr. Abc XyzSheth.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

H/O left sided hemiparesis 4 years back from which patient has recovered.
Now C/O memory lapses especially for recent events.
Known 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.

OBSERVATION :

There is a hyperintense area on the T2 Weighted images in the right temporo-occipital region. This is hypointense to white matter on the T1 Weighted images. This represents an area of cystic encephalomalacia. There is ex-vacuo dilatation of the occipital horn of the right lateral ventricle.

Hyperintense areas on the T2 Weighted images in the fronto-parietal and periatrial white matter are prohably ischemic in etiology. Lacunes are seen in the thalamus and lentiform nucleus on the right side.

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

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

INTRACRANIAL MRA :

The vertebro-basilar system is ectatic.
..2/.






There is narrowing of the supraclinoid segment of the left internal carotid artery.

There is flow signal attenuation within the right posterior cerebral artery.

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

The right vertebral artery is smaller in calibre as compared to the opposite side and shows streaky flow.

NECK MRA :

The right vertebral artery is smaller in calibre as compared to the opposite side and shows streaky flow.

The common carotid arteries and their extracranial branches appear normal bilaterally.

IMPRESSION :

1. An area of cystic encephalomalacia in the right temporo-occipital region.

2. Altered signal in the fronto-parietal and parietal white matter is most probably ischemic in etiology.

3. Narrowing of the supraclinoid portion of the right internal carotid artery and flow signal attenuation within the right posterior cerebral artery.

4. The right vertebral artery is smaller in calibre as compared to the opposite side and shows streaky flow.