Male, 72 years old, with mild cognitive impairment and recent impulsive behavior, concern for frontotemporal dementia. Extensive, almost confluent periventricular white matter T2 hyperintensity is seen. Some areas appear very cystic or cavitated compatible with chronic lacunar infarctions. No restricted diffusion is seen to suggest acute ischemia.No evidence of parenchymal edema or mass effect is seen. No abnormal extra-axial fluid collections are detected. No acute intracranial hemorrhage is suspected, though there are scattered foci of susceptibility which likely reflect chronic microscopic blood product.The sulci of the cerebral hemispheres and the ventricular system are moderately and symmetrically prominent compatible with underlying volume loss. There is, however, no specific distribution to this volume loss. In particular, features associated with frontotemporal dementia such as "knife edge" sulci in the frontal and temporal lobes are not seen.
1.No acute intracranial abnormality.2.No specific findings to suggest frontotemporal dementia.3.Moderate generalized parenchymal volume loss is noted, in the context of fairly extensive chronic microvascular and lacunar ischemic disease. Constellation of findings along with the clinical history would suggest multi-infarct dementia.