Clinical question: Indeterminate/dementia. Signs and symptoms: Memory decline, visual spatial impairment and cognitive dysfunction. Nonenhanced brain MRI:No diffusion weighted abnormalities. Examination redemonstrate periventricular and subcortical foci of nonspecific flair hyperintensity only in bilateral cerebral hemispheres without associated susceptibility signal changes. Although nonspecific this appearance is often result of microvascular ischemic changes. Findings remain very similar to prior exam and with only questionable minute interval progression. The overall anatomical morphology and signal intensity of brain parenchyma otherwise remains within normal patient's stated age. The cerebral cortex demonstrate no signal abnormality. The ventricular system remain within normal size and with maintained midline.The signal voids of major intracranial arterial branches are identified and unremarkable.The signal intensity of the intracranial venous sinuses are also normal.Calvarium and soft tissues of the scalp are unremarkable. Unremarkable images through the orbits, paranasal sinuses and mastoid air cells.
1.No acute intracranial process and negative diffusion weighted images.2.Findings suggestive of mild chronic small vessel ischemic strokes without convincing evidence of any significant interval change since prior exam. Findings are entirely confined in the periventricular and subcortical white matter of cerebral hemispheres.