Clinical question: Patient with memory loss, consent for history of strokes. Signs and symptoms: As above. Nonenhanced brain MRI:Negative diffusion-weighted images.There are several small foci of FLAIR and T2 hyperintensity in the periventricular and subcortical white matter of cerebral hemispheres and minimally in the left basal ganglia as well as pons which considering patient's stated age of 83 likely representing chronic microvascular ischemic changes without evidence of hemorrhagic changes.The cerebral cortex as well as cortical sulci and ventricular systems remain within normal for stated age and with maintained midline.Signal void of major intracranial arterial branches are identified. The signal intensity of the intracranial venous sinuses are unremarkable.Unremarkable calvarium, orbits and mastoid air cells. Extensive left maxillary chronic sinus disease and unremarkable paranasal sinuses otherwise.
1.No acute intracranial process.2.Mild chronic nonhemorrhagic small vessel ischemic strokes only in the subcortical and periventricular white matter and minimally of the left basal ganglia and pons.3.Unremarkable brain MRI otherwise for stated age.4.Left maxillary sinusitis and unremarkable other paranasal sinuses