Reason: Pt has mild cognitive impairment, evaluate for vascula disease and atrophy History: Mild cognitive impairment, MOCA = 19/30 The CSF spaces are appropriate for the patient's stated age with no midline shift. There is a mild degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images.Subdural effusion the posterior fossa is most often related to atrophy.No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses are clear. There is a right maxilla are old healed or lesion which protrudes into the floor of the right maxillary sinus and is relatively dark on T2 The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. The AP dimension of the left eye is significantly increased. The right eyeball lens is thin.
1.Periventricular and subcortical white matter changes of a mild degree are nonspecific. At this age they are most likely vascular related. 2.Left-sided buphthalmos.3.No evidence for acute ischemic cerebral infarction or microhemorrhage.4.Alveolar maxillary bone lesions are present which are incompletely evaluated. One possibility is that they are odontogenic. Please correlate with prior dental history. Further evaluation with plain film or CT exam may be helpful to further evaluate this.