Brief Answer:
Please find detailed answer as given below.

Detailed Answer:
Hi XXXXX,
Thanks for writing in to us.

I have gone through your query and attached reports in detail and will explain the MRI brain and angiography findings in simple language.

1. Short segment moderately severe narrowing in the C2 portion of the left ICA

The front portion of brain receives its blood supply from the heart through the XXXXXXX carotid arteries (one on each side). This further branches into the smaller anterior and posterior cerebral arteries which supply the brain. The XXXXXXX carotid artery is divided into many segments along its course.

The petrous segment, or C2, of the XXXXXXX carotid is that which is inside the petrous part of the temporal bone (side of face near the ear). The petrous portion classically has three sections: an ascending, or vertical portion; the genu, or bend; and the horizontal portion. it is mentioned in the report that there is a short segment 62% luminal narrowing in the XXXXXXX carotid artery on left side in the portion. At the moment it is not very serious but medications need to be taken to prevent stroke.

2. Grade 2 vascular loop of right AICA n entering into the right XXXXXXX auditory meatus - ?causing nuerovascular conflict with CN-VII & VIII

The AICA is anterior inferior cerebellar artery (which supplies blood to the back portion of brain) which may form loops near the cerebellopontine angle (near deepest portion of ear inside the skull) and is graded as vascular loops types according to the Chavda classification:

type I loops contact the cochlear nerve in the cerebellopontine angle but do not enter the XXXXXXX auditory canal (IAC),
type II loops enter the IAC and extend less than 50% of its total length,and
type III loops extend greater than 50% into the total length of the IAC.

This loop is of grade 2 in your brother and may compress the cochlear nerve (nerve of hearing) and also occupy the space between the facial and cochlear nerves (Cranial Nerves VII and VIII respectively) as is mentioned in your brother's report. This can cause hearing loss in a patient.

I would like to know the problems being faced by your brother and any relevant clinical details.

Hope your query is answered.
Waiting for an update from your end.

Regards,
Dr.Vivek.

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Brief Answer:
Please consult neurologist and cardiologist.

Detailed Answer:
Hi XXXXX,
Thanks for writing in with an update.

The treatment goal remains prevention of further narrowing in the C2 segment of left XXXXXXX carotid artery (ICA) and decreasing any nerve related problems (including hearing loss or vertigo).

You must consult a neurologist and cardiologist who may prescribe medicines like anti coagulants which will prevent further narrowing of the artery and other medications for nerve related problems. Please consult your doctors regularly and tell your brother to take medicines on time. He must also adapt a healthy diet and fitness plan.

Hope your query is answered.
Do write back in case of doubts.

Regards,
Dr.Vivek.

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