 There is moderate volume loss involving the bilateral hippocampi with abnormal FLAIR signal involving the left amygdala extending to the left hippocampal head. There is suggestion of cystic change without definite mass effect. Multiple foci of white matter T2 hyperintensity is most compatible with age indeterminate small vessel ischemic disease. There is no restriction diffusion or susceptibility weighted imaging abnormality. There is no midline shift or mass effect. There is no diffusion abnormality. No extra-axial fluid collection is identified. Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits. Mucosal thickening is noted in the left maxillary sinus.
1.Abnormal FLAIR signal involving the left medial temporal including the amygdala and left hippocampal head. There is suggestion of cystic change without clear evidence of mass-effect. Finding is favored to represent gliosis related to chronic injury (including prior ischemia or infection). Suggest obtaining prior studies for comparison if available or consider high-resolution imaging of the hippocampi at 3T with intravenous contrast to exclude other less likely etiologies including neoplasm. 2.There are no findings to suggest frontotemporal degeneration. Mild chronic small vessel ischemic changes.