hs/sb
Date : 00.00.00

Name of the Patient : Abc XyzB. lmn / F / 45 yrs.
Referred by : Dr. Abc Xyzmpat.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O weakness of the RUE and RLE since 00.00.00.

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 prominence of the cerebral cortical sulci with loss of volume of the left fronto-parietal lobes (frontal more than parietal). Hyperintense areas on the T2 Weighted images are noted within these lobes, which would most likely represent gliotic changes (? the result of a previous vascular insult). There is ex-vacuo dilatation of the left lateral ventricle and prominence of the left Sylvian fissure.

There is prominence of the cerebellar folia bilaterally. The left cerebral peduncle is decreased in volume (may represent Wallarian degeneration).

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

The left frontal sinus is overpneumatized.




- 2 - Scan - 00002

INTRACRANIAL MRA :

There is attenuation of the flow signal in the distal aspect of the M1 segment of the left middle cerebral artery. Also seen is a paucity of the Sylvian branches of the left middle cerebral artery.

The right posterior communicating artery is prominent. The right vertebral artery is slightly hypoplastic. The A1 segment of the right anterior cerebral artery is hypoplastic.

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

NECK MRA :

The right vertebral artery is slightly 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 :

The MRI/MRA features are suggestive of :

1. Areas of encephalomalacia in the left fronto-parietal lobes (frontal more than parietal), with volume loss, suggesting left cerebral hemiatrophy.

2. Cerebellar atrophy.

3. Attenuation of the flow signal of the distal aspect of the M1 segment of the left middle cerebral artery and a paucity of the Sylvian branches of the left middle cerebral
artery.