Clinical question: History of brain surgery 9 years ago for subdural hematoma. Signs and symptoms: Memory loss. Nonenhanced brain MRI:No acute intracranial process and negative diffusion weighted series.Examination demonstrate expected chronic postoperative changes of a right parietal small craniotomy.Mild scattered patchy foci of FLAIR/T2 hyperintensity are present only in the subcortical and periventricular white matter of bilateral cerebral hemispheres. Although nonspecific considering patient's stated age of 88 this appearance is highly suggestive of chronic microvascular ischemic changes of mild degree. The signal intensity of brain parenchyma is otherwise within normal on all MRI sequences.There is generalized symmetrical bilateral prominence of cortical sulci which could be within normal range for patient's stated age. Ventricular system are normal and with maintained midline. CSF spaces remain patent and unremarkable.The signal void of major intracranial arterial branches are present.Images through the orbits, paranasal sinuses, mastoid air cells and calvarium are unremarkable.
1.No acute intracranial process and negative diffusion weighted series.2.Findings suggestive of mild chronic nonhemorrhagic small vessel ischemic strokes only in the subcortical and periventricular white matter.3.Essentially unremarkable nonenhanced brain MRI otherwise for patient's stated age of 88. Please see above comments.