ke/hs/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzi lmn / M / 78 yrs.
Referred by : Dr. Abc Xyzrani.
Examination : M.R.I. of the Brain and
Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O gait imbalance and speech disturbances since 3 months with hearing loss on the left side since 4-5 years.

EXAMINATION :

M.R.I. of the brain was performed using the following parameters:

5 mm thick T1 Weighted, proton and T2 Weighted axial images.

5 mm thick FLAIR coronal images.

MR Cisternogram was obtained in the coronal plane.

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

OBSERVATION :

BRAIN :

There are hyperintense areas on the proton, T2 Weighted and FLAIR images in the bilateral periatrial white matter. These are isointense to white matter on the T1 Weighted images and are probably ischemic in etiology.

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

Mild inflammatory changes are noted in the right mastoid air cells.
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INTRACRANIAL MRA :

The left vertebral artery is hypoplastic.

There is slight flow signal attenuation within the distal aspect of the M1 segment of the left middle cerebral artery.

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, 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 in the neck also appears hypoplastic.

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 altered signal in the bilateral periatrial white matter are probably ischemic in etiology.

2. Age related cerebral and cerebellar atrophy.

3. Slight flow signal attenuation within the distal aspect of the M1 segment of the left middle cerebral artery.