Neuro_MR_Brain: 58 M, memory loss and confusion.

MR Diagnosis Stroke Protocol

 

HISTORY: Male who is 58 years old with history of transient memory loss and confusion.

 

FINDINGS: 

Two symmetric foci of restricted diffusion are seen within the bilateral CA1 hippocampal formations.

 

The ventricles and sulcal size are normal for patient's age. There are periventricular and subcortical white matter signal intensities which may represent small vessel ischemic changes.

 

There is no acute intracranial hemorrhage, mass effect, or midline shift. There are no focal parenchymal signal abnormalities present. 

Abnormal intra-axial or extra-axial fluid collections are not present. 

There is no abnormal enhancement on postcontrast images.

 

The orbits, paranasal sinuses, mastoid air cells, flow-voids at the skull base, and cervicomedullary junction are preserved.

 

MR PERFUSION:

Symmetric brain perfusion is shown without evidence of focal perfusion abnormality.

 

ASL: 

Symmetric brain perfusion is shown without evidence of focal perfusion abnormality.

 

MRA:

The origins of the brachiocephalic vessels from the aortic arch are within normal limits. Both vertebral arteries have normal origins and are seen to fill the basilar without evidence of stenosis. Bilateral 

common carotid arteries, their bifurcations, and cervical internal carotid arteries are normal in course in caliber, without significant stenosis or flow gap is identified.

 

Bilateral intracranial ICAs, MCAs, ACAs and the anterior communicating artery are patent. Bilateral vertebral arteries and posterior cerebral arteries are patent. The basilar artery is normal in course in caliber, without significant stenosis or flow gap is identified. The right vertebral artery terminates in the PICA

complex. The left vertebral artery is dominant.

 

IMPRESSION: 

 

1. Bilateral symmetric punctate hippocampal formation restricted diffusion, compatible with transient global amnesia.

 

2. Probable small vessel ischemic changes.