Mild cognitive impairment, daily marijuana use. There is moderate degree of global parenchymal volume loss with relatively greater involvement of the frontal and parietal lobes. No disproportional volume loss involving the hippocampi seen. No intracranial mass or mass-effect. No restricted diffusion to suggest acute ischemia. No intracranial hemorrhage. No hydrocephalus. Mega cisterna magna incidentally noted. Several foci of T2/FLAIR hyperintensity are seen in the bilateral subcortical and periventricular white matter, which are nonspecific, but compatible with mild chronic small vessel ischemic changes. No large vascular distribution infarcts. Brain parenchyma is otherwise unremarkable for age. Major flow-voids are preserved.Mild mucosal thickening in the paranasal sinuses with small mucous retention cysts in the left maxillary and left frontal sinuses. Bone marrow signal and extracranial soft tissues are within normal limits.
1. No intracranial mass or mass effect.2. Moderate global parenchymal volume loss appears appropriate for patient's age. 3. Mild chronic small vessel ischemic changes.