Cognitive decline and prior MRI with abnormal left hippocampal signal: memory loss. Redemonstrated are diffuse areas of high T2 signal in the left amygdala and hippocampus without appreciable mass effect. There is also a subcentimeter ovoid T2 hyperintense focus in the left temporal stem, which may represent a prominent perivascular space. The right hippocampus appears to be intact. Multiple scattered foci of T2 hyperintensity in the cerebral white matter are nonspecific, but may represent chronic small vessel ischemic disease. There is no evidence of intracranial hemorrhage, mass, or acute infarct. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, and scalp soft tissues are grossly unremarkable. There are retention cysts in the maxillary sinuses.
Persistent signal abnormality in the left amygdala and hippocampus is incompletely characterized without intravenous contrast administration. Nevertheless, differential considerations include prior ischemia, dyplasia, or infection, for example.