Memory, behavior changes and tremor. Evaluate for inflammatory changes. There is no evidence of acute intracranial hemorrhage, mass, or acute infarct. There are several punctate foci of nonspecific T2 hyperintensities scattered in the white matter of the cerebral hemispheres bilaterally, most likely representing chronic small vessel ischemic change and similar to prior. Again seen is bilateral symmetric high T2/FLAIR signal in the inferior dorsal pons at the level of the aqueduct and superior cerebellar peduncles. The ventricles and basal cisterns are unchanged in size and configuration. There is mild global parenchymal volume loss including the hippocampi in a nonspecific pattern. There is no midline shift or herniation. The skull and extracranial soft tissues are unremarkable. Unchanged appearance of the globes which are enlarged.
1. No evidence of acute infarct, hemorrhage, mass, or edema. No findings to suggest an active inflammatory process although gadolinium might be helpful.2. Compared to 5/5/2011, no significant change in bilateral symmetric high T2/FLAIR signal in the inferior dorsal pons which may be related to remote inflammatory, toxic-metabolic, or demyelinating injury.3. Nonspecific mild white matter changes which are nonspecific but compatible with mild chronic small vessel ischemic disease. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.