sb/ke/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzlmn / M / 60 yrs.
Referred by : Dr. Abc Xyzah.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O sudden onset of gait ataxia, slurred speech and altered sensorium since 20 days.
Old C/O anteroseptal myocardial infarction with LV dysfunction with LV clot.

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 area on the T2 Weighted images in the right temporo-parietal region. This lesion appears hypointense on the T1 Weighted images and represents an area of cystic encephalomalacia, most likely the sequelae of a previous vascular insult.

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

Inflammatory changes are noted in the right maxillary antrum and right ethmoidal air cells.

INTRACRANIAL MRA :

There is slight attenuation of the Sylvian branches of the right middle cerebral artery.


The petrous, cavernous and supraclinoid segments of the internal carotid arteries bilaterally show normal signal and calibre. The visualized anterior cerebral, left 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.

IMPRESSION :

1. Altered signal in the right temporo-parietal region
represents an area of cystic encephalomalacia, most likely the sequelae of a previous vascular insult.

2. Slight attenuation of the Sylvian branches of the right middle cerebral artery.

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