History of major concussion, changes in memory. No restricted diffusion to suggest acute ischemia. No intracranial hemorrhage. No intracranial mass or mass-effect. The ventricles are within normal limits in size and configuration. Incidental note is made of xanthogranulomatous cysts. There is mild supratentorial and infratentorial volume loss including the superior cerebellar vermis. No particular volume loss involving the hippocampi.Several foci of T2/FLAIR hyperintensity are seen in the bilateral subcortical and periventricular white matter, which are nonspecific, but compatible with mild chronic small vessel ischemic changes. Brain parenchyma is otherwise unremarkable for age.No abnormal parenchymal or meningeal enhancement. Major flow-voids are preservedSella and orbits are grossly within normal limits. Paranasal sinuses and mastoid cells are clear. Bone marrow signal and extracranial soft tissues are within normal limits.
1.Mild chronic small vessel ischemic changes. No intracranial hemorrhage or mass effect.2.There is mild global volume loss which appears within normal limits for age. There is mild relative increased volume loss involving the superior cerebellar vermis which is nonspecific but can be seen with chronic alcohol use. Examination is otherwise unremarkable.