 There is asymmetric volume loss within the left temporal lobe as well as less so throughout the entire left cerebral hemisphere. There is no evidence of intracranial hemorrhage, mass, or acute infarct. There is a small focus of T2 hyperintensity within the left paramedian cerebellum which likely represents chronic ischemia. There is no abnormal intracranial enhancement. There is no midline shift or herniation. The major cerebral flow voids are intact. The skull, paranasal sinuses, and scalp soft tissues are unremarkable.
Asymmetric volume loss of the left cerebral hemisphere most prominent in the left temporal lobe may be seen in the clinical setting of semantic dementia. 