Clinical question: Patient has memory impairment, evaluate for brain atrophy. Signs and symptoms: Memory impairment. Nonenhanced brain MRI:Unremarkable diffusion weighted series.Examination demonstrates a few punctate nonspecific subcortical and periventricular low-attenuation white matter which are nonspecific. Considering patient's stated age possibility of minute chronic nonhemorrhagic small vessel ischemic strokes considered.There is mild prominence of parietal cortical sulci and unremarkable cerebral cortex, cortical sulci, ventricular system, CSF spaces and brain myelination otherwise for patient's stated age of 77.The signal void of major intracranial arterial branches are identified.Unremarkable calvarium, soft tissues of the scalp, orbits, paranasal sinuses and mastoid air cells.
1.No acute intracranial process.2.Findings suggestive of very minimal chronic nonhemorrhagic small vessel ischemic strokes.3.Mild prominence of parietal cortical sulci which may be at the upper limits of normal and unremarkable brain MRI otherwise for patient's stated age