Female, 58 years old, with dementia. No evidence of restricted diffusion, parenchymal edema or mass effect is seen. However, substantial diffuse cerebral volume loss is seen, with particular atrophy of the hippocampi. The cerebellum is spared. No pathologic intracranial enhancement is seen. No evidence of acute intracranial hemorrhage or any abnormal extra-axial fluid collections are detected. There is mild T2 hyperintense rimming of the ventricles, and the atrophic hippocampi are also mildly T2 hyperintense. Scattered foci of susceptibility are nonspecific and may reflect chronic microhemorrhage or mineralization. A few scattered foci of T2 hyperintensity in the periventricular white matter are nonspecific.
Diffuse cerebral atrophy is seen with particular involvement of the hippocampi. These findings would be compatible with a chronic neurodegenerative process such as Alzheimer's disease. No definite acute lesions are detected.