Dementia and gait disorder, question of NPH: wide base gait. There is no evidence of intracranial hemorrhage or acute infarct. There is interval increased subcortical white matter T2 hyperintensity in the posterior left temporal lobe, without discernible associated mass. There are also slightly progressed mild scattered areas of T2 hyperintensity in the cerebral white matter, particularly in a periventricular distribution. The ventricles and sulci are diffusely prominent, but similar to 2012. There is no apparent prominent CSF flow jet in the third ventricle. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.
1. Diffuse cerebral volume loss appears to be unchanged since 2012 without a pattern to suggest a particular neurodegenerative condition. 2. Increased subcortical white matter signal abnormality in the posterior left temporal lobe and slightly progressed cerebral white matter lesions elsewhere may be related to chronic ischemic disease, but are incompletely characterized and nonspecific.3. No evidence of acute intracranial hemorrhage or acute infarct.