Date : 00.00.00

Name of the Patient : Abc Xyzhai D. Jhalmn / M / 75 yrs.
Referred by : Dr. Abc Xyz Mehta.
Examination : M.R.I. of the Brain and
Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O seizures since 5 years back.
C/O giddiness with ? seizure on 00.00.00.
Known hypertensive.

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.

3 mm thick T2 Weighted coronal images.

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

OBSERVATION :

BRAIN :

There are small bright foci on the proton, T2 Weighted and FLAIR images in the right frontal deep white matter and in the left cerebellar hemisphere (scans 106.13, 17, 18, 102.4). These lesions appear isointense to hypointense to normal white matter on the T1 Weighted images and most likely represents ischemic changes.

There is mild to moderate dilatation of both the lateral and third ventricles. The fourth ventricle is normal.

There is prominence of the cerebral cortical sulci, cerebellar folia and basal cisternal spaces bilaterally.
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There is no shift of the midline structures.

Prominent perivascular spaces are noted in the centrum semiovale bilaterally.

The hippocampal complex is unremarkable on either side.

INTRACRANIAL MRA :

There is ectasia of the vertebro-basilar system and the left middle cerebral artery. The intracranial segment of the right vertebral artery is not visualized.

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, 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 in the neck is also not visualized. The left vertebral artery, common carotid arteries and their bifurcations are unremarkable.

There are no vessel wall irregularities or stenosis of the vessels noted.

IMPRESSION :

1. Small bright foci on the proton, T2 Weighted and FLAIR images in the right frontal deep white matter and in the left cerebellar hemisphere most likely represent ischemic changes.

2. Ectatic vertebro-basilar system and left middle cerebral artery.

3. Non-visualization of the right vertebral artery in its entirety.