Reason: Cognitive decline following cardiac surgery History: memory impairment and visuospatial difficulty. There is mild prominence of the ventricles as well as sulcal prominence predominantly involving the perirolandic areas and parietal lobes with relative sparing of the occipital and temporal lobes. The basal cisterns remain patent. There is no midline shift or mass effect. There are several punctate foci of increased T2/FLAIR signal within the subcortical and periventricular white matter which are nonspecific but compatible with minimal chronic small vessel ischemic changes. 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. The orbits, skull, and scalp soft tissues are grossly unremarkable. There is trace mucosal thickening within the paranasal sinuses. The mastoid air cells are clear.
1.No evidence of acute intracranial hemorrhage, mass, or acute infarct.2.Mild brain atrophy localized to the perirolandic regions and parietal lobes with sparing of the remainder of the brain parenchyma which is nonspecific, however, corticobasal degeneration has been reported to present in a similar fashion.3.Minimal chronic small vessel ischemic changes.