sb/ke
Date : 00.00.00

Name of the Patient : Abc Xyz C.lmn / F / 50 yrs.
Referred by : Dr. Abc Xyznamiya.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

H/O slurred speech (2 episodes) since 2 days.
Known diabetic. On Rx.
H/O coronary angioplasty done.

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 occipital cortex which may represent an ischemic lesion (scans 102.9).

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

INTRACRANIAL MRA :

There is non-visualization of the petrous, cavernous and supraclinoid segments of the left internal carotid artery. Faint visualization with narrowing of the cavernous and supraclinoid segment of the right internal carotid artery is noted. Slight irregularity of the proximal segment of the left middle cerebral artery is noted.

The petrous segments of the right internal carotid artery shows 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.
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NECK MRA :

The right common carotid artery and its bifurcation and the vertebral arteries on either side are unremarkable.

The left common carotid artery is unremarkable. The left internal carotid artery not visualized right from its origin. The left external carotid artery is unremarkable.


IMPRESSION :

1. Altered signal in the left occipital cortex may represent an ischemic lesion.

2. Non-visualization of the left internal carotid artery in its entirety, right from its origin in the neck.

3. Faint visualization and narrowing of the cavernous and supraclinoid segment of the right internal carotid artery.

4. Slight irregularity of the proximal segment of the left middle cerebral artery..

The above described vascular changes may be due to atherosclerosis.