History of ataxia, pseudotumor effect, mild cognitive impairment; evaluate for structural abnormalities. The lateral and third ventricles and Sylvian fissures are disproportionately prominent with respect to the cerebral sulci. There is a prominent jet of cerebrospinal fluid jet in the third ventricle. There are unchanged scattered punctate foci and confluent areas of abnormal T2 hyperintensity within the periventricular and subcortical white matter. There is no midline shift or herniation. There is no evidence of intracranial hemorrhage, mass, or acute infarct. The major cerebral flow voids are intact. There is minimal bilateral maxillary sinus mucosal thickening and retention cyst in the left maxillary sinus. The orbits, skull and scalp soft tissues are grossly unremarkable.
1. Findings suggestive of normal pressure hydrocephalus.2. Cerebral white matter hyperintensities are nonspecific, but likely represent chronic small vessel ischemic disease.3. No evidence of acute intracranial hemorrhage, mass, or acute infarct.