Right anterior cerebral artery territory infarction (MR).

PROTOCOL:

T1W – Sagittal & axial scans
T2W – Axial & coronal scans
FLAIR – Axial scans 

FINDINGS:

-Revealed:
• Large area of acute infarction with diameters of about 166 mm (AP) and 27 mm (transverse orientation).
• Right frontal situation with hypo intensity on T1; hyper intensity on T2 and Flair with restricted diffusion on both diffusion and ADC maps images.
• Corpus callosal affection.
• Old lacunar infarct left basal ganglia and right side of the pons.
• Multiple small variables sized linear foci in the left basal ganglia with blooming effect on gradient images and surrounded gliosis on T2 and Flair images(suggestive of vascular lesion).
• Non visualization of the anterior cerebral artery with attenuation of both middle cerebral arteries specially the left one.
• Evident beading appearance of vessels especially in the region of the right middle cerebral artery.
• Multiple attenuated areas involving carotid and basilar arteries.

-The rest of the brain Parenchyma shows normal grey white matter differentiation and signal intensities.  No focal mass lesion is seen.
-Lateral and third ventricles are normal in size and position. Septum is in midline.  There is no midline shift.
-Cerebellum show normal signal intensities.  
-Fourth ventricle is normal in size and is midline in position.


OPINION:

• Picture is suggestive of massive right cerebral artery territory infarction with affection of the corpus callosum and at least two lacunar infarcts in the left basal ganglia and right pons.
• In light of age of patient; multiplicity of lesions in addition to beading appearance of cerebral arteries; vasculitis should be considered.
• For clinical correlation.


Reported By : DR.MOHAMMED MOHYELDIN
 Consultant-Radiologist
Report Status : Validated / Validated By :  Dr.Mohammed Mohyeldin