Clinical question: Atrophy. Signs and symptoms: Memory loss. Nonenhanced head CT:The cortical sulci, ventricular system and CSF cisterns are within normal range for patient's stated age of 85.Periventricular and subcortical patchy foci of low attenuation are concerning for mild small vessel ischemic strokes of indeterminate age.MRI is more sensitive for assessment of the extent of this finding.Mild calcification of cavernous carotid bilaterally is present.No evidence of intracranial hemorrhage, edema, mass-effect, midline shift or hydrocephalus.Calvarium is intact.Image images through the orbits are unremarkable.Mastoid air cells and middle ear cavities as well as all visualized paranasal sinuses are unremarkable.
Mild small vessel ischemic strokes of indeterminate age and unremarkable exam otherwise. In particular no convincing evidence of atrophy for patient's stated age.