Dementia, cerebral atrophy, evaluate for progressive dementia. Diffuse cerebral parenchymal volume loss is again seen which has minimally progressed since 12/17/2010. Prominent CSF space the level of the parieto-occipital sulcus and calcarine fissure are again noted. No disproportional volume loss involving the hippocampi is appreciated. There is prominence of the ventricular system which is minimally larger compared to 12/17/2010. Again seen are multiple foci of T2/FLAIR hyperintensity in the bilateral subcortical and periventricular white matter, which are nonspecific, but compatible with mild-to-moderate chronic small vessel ischemic changes and minimally progressed since 12/17/2010. No restricted diffusion to suggest acute ischemia. No intracranial hemorrhage. No intracranial mass or mass-effect. Major flow-voids are preserved.There is moderate mucosal thickening involving the bilateral maxillary sinuses and minimal thickening elsewhere. Bone marrow signal and extracranial soft tissues are within normal limits. Evidence of intraocular lens replacement bilaterally.
1. No intracranial mass or mass effect.2. Mild to moderate chronic small vessel ischemic changes have minimally progressed since 12/17/2010.3. Nonspecific pattern of diffuse cerebral parenchymal volume loss has minimally progressed since 12/17/2010, with relatively greater involvement of the bilateral frontal and parietal lobes and unchanged focal prominence of the CSF spaces at the parieto-occipital sulcus and calcarine fissure. Possible disproportional prominence of the ventricles for the degree of volume loss and aforementioned focal CSF spaces raises possibility of communicating hydrocephalus/NPH, in the appropriate clinical setting.