Diagnosis: Mild cognitive impairment, so statedClinical question: Alzheimer vs alcoholic memory losses vs OSASigns and Symptoms: memory problems, name remembering difficulty The CSF spaces are appropriate for the patient's stated age with no midline shift. There is a 79x38mm coronal dimension cyst is centered in the right middle cranial fossa which is associated with remodeling of the adjacent bone. There is a 26x35mm coronal dimension cyst centered in the left middle cranial fossa.There is a mild degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images. There is a punctate T2 and FLAIR hyperintense focus in the pons.No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.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 demonstrate mucosal thickening in the maxillary sinuses and ethmoid air cells. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. The eye lenses are thin.There is a defect present along the odontoid process.
1.Bilateral middle cranial fossa arachnoid cysts. The one on the right is large.2.Periventricular and subcortical white matter changes of a mild degree and a punctate pontine lesions are nonspecific. At this age they are most likely vascular related. 3.There is a defect present along the odontoid process. A chronic fracture cannot be excluded. If clinically appropriate, CT of the cervical spine may help further evaluate this.4.An email was sent to Dr Mastrianni.