Male, 59 years old, with memory decline. Numerous scattered foci of T2 hyperintensity are seen within the white matter of the cerebral hemispheres. These are primarily juxtacortical, and to a lesser degree periventricular in distribution. No significant involvement of the basal ganglia, brainstem or cerebellum is seen.There is no evidence of restricted diffusion. No parenchymal edema or mass effect is detected. No acute intracranial hemorrhage or abnormal extra-axial fluid collections are noted. The lateral ventricles may be slightly prominent. The cerebral sulci in general are of normal caliber, though the sylvian fissures appear mildly prominent.
1.Numerous, likely chronic, scattered small white matter lesions are seen in the cerebral hemispheres, largely juxtacortical in location but with mild involvement of the periventricular regions as well. The basal ganglia, brainstem and cerebellum are spared. The distribution is somewhat atypical for small vessel ischemic disease though correlation with risk factors is suggested. Other considerations would include sequelae of prior inflammation, demyelination or vasculitis.2.No definite acute intracranial abnormality is seen nor are there any other specific findings which would account for the patient's memory decline. The lateral ventricles appear to be slightly prominent and there may be some prominence of the sylvian fissures suggesting a component of mild parenchymal volume loss.