sb/hs/rg.
Date: 00.00.00

Name of the Patient : Abc Xyzana lmn / F / 73 yrs.
Referred by : Dr. Abc Xyzmpat.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O headaches, vomiting and altered sensorium at 6.00 pm on 00.00.00.
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.

OBSERVATION :

There is an ill-defined hyperintense signal on the T2 Weighted images in the left cerebellar hemisphere, inferiorly and along the right temporal cortex. These lesions appear iso to hypointense to normal white matter on the T1 Weighted images and most likely represent ischemic lesions, probably recent, in the given clinical setting.

Lacunar infarcts (iso to hyperintense to CSF) are noted in the right cerebellar hemisphere, bilateral thalami, lentiform nuclei, head of the left caudate nucleus and in the corona radiata bilaterally.

Ill-defined, hyperintense signal on the T2 Weighted images is seen in the periventricular white matter bilaterally and in the subcortical white matter in the left fronto-temporal region and in the right frontal region.

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

Incidentally noted is hyperostosis frontalis interna.
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INTRACRANIAL MRA :

There is slight narrowing of the cavernous segment of both the internal carotid arteries.

The left vertebral artery is not well-identified.

The petrous and supraclinoid segments of the internal carotid arteries bilaterally show normal signal and calibre. The visualized anterior cerebral, middle cerebral, basilar, right 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 faintly visualized in the neck. The external carotid arteries also show attenuated flow signal, distal to the common carotid arteries bilaterally.

The common carotid arteries and their bifurcations are unremarkable. The proximal internal carotid arteries are also unremarkable.

IMPRESSION :

1. Altered signal in the left cerebellar hemisphere, inferiorly and along the right temporal cortex most likely represent ischemic lesions, probably recent, in the given clinical setting.

2. Lacunar infarcts in the right cerebellar hemisphere, bilateral thalami, lentiform nuclei, head of left caudate nucleus and in the corona radiata bilaterally.

3. Altered signal in the periventricular white matter bilaterally and in the subcortical white matter in the left fronto-temporal region and in the right frontal region represent ischemic changes.

4. Attenuated flow signal of the external carotid arteries bilaterally.
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5. The left vertebral artery is not well-visualized.

6. Slight narrowing of the cavernous segment of both the internal carotid arteries.

As compared to the previous MRI (study no.00000) dated 00.00.00, the lesions in the left cerebellar hemisphere, inferiorly and in the right temporal cortex were not identified on the previous study.