68-year-old female with left temporal slowing. Evaluate for seizure focus. There is no evidence of intracranial hemorrhage, mass, or acute infarct. There is extensive T2 hyperintensity throughout much of the cerebral white matter. There is no focal hippocampal lesion. There is no abnormal intracranial enhancement. There is diffuse cerebral and cerebellar volume loss. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, and scalp soft tissues are grossly unremarkable. There is mild left maxillar sinus mucosal thickening.
Extensive cerebral volume loss and white matter abnormality may represent chronic small vessel ischemic disease. Otherwise, no evidence of intracranial hemorrhage, mass, or acute infarct. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.