77 years Female (DOB:4/14/1938)Reason: Cognitive decline. Please assess for cerebrovascular disease and volume loss History: cognitive impairmentPROVIDER/ATTENDING NAME: JAMES A. MASTRIANNI JAMES A. MASTRIANNI There is abnormal T2 hyperintense and T1 hypointense signal present at the splenium of the corpus callosum.There is T2 hyperintense signal present along the subcortical white matter of the posterior aspect of the right middle temporal gyrus.The lateral ventricles are dilated. The temporal horns are relatively large. The third ventricle is wide measuring 9 mm with. Biventricular diameter at the level of foramen of Monro is 41 mm.There are punctate FLAIR and T2 hyperintense lesions present in the thalami bilaterally and to a lesser degree in the brainstem.There is a peripherally height O intense and centrally hyperintense lesion on T2-weighted imaging measuring 7 mm in diameter associated with susceptibility effect and located in the right parietal lobe adjacent to the medial aspect of the intraparietal sulcus.There is a mild degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images. Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
1.There is a hemorrhagic focus present in the right parietal lobe measuring 7 mm in size which is suspected to represent a cerebral cavernous malformation.2.Findings suggest myelomalacia along the splenium of the corpus callosum.3.Findings suggest mild ventriculomegaly of unknown cause. At this age and most likely related to brain atrophy but is nonspecific and the possibility of normal pressure hydrocephalus in the appropriate clinical setting cannot be excluded.4.Periventricular and subcortical white matter lesions as well as a few punctate lesions in the brainstem and thalami are nonspecific. At this age they are most likely vascular related. 