Concern for Korsakoff syndrome. There is no evidence of intracranial hemorrhage, mass, or acute infarct. There is patchy high T1 signal within the bilateral basal ganglia and perhaps the pituitary gland. The ventricles and sulci are diffuse prominent due to cerebral volume loss. There are diffuse foci of cerebral white matter T2 hyperintensity. There are are few punctate foci of susceptibility effect in the bilateral frontal lobes. There is no midline shift or herniation. The major cerebral flow voids are intact. The skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable. There is a left lens implant. The partially imaged upper cervical spine bone marrow appears mildly heterogeneous, which is nonspecific, and there are mild posterior disc-osteophyte complexes.
1. Patchy high T1 signal within the bilateral basal ganglia and perhaps the pituitary gland suggest chronic alcoholic encephalopathy. 2. Diffuse foci of cerebral white matter T2 hyperintensity is nonspecific, but may represent chronic small vessel ischemic disease. 3. A few punctate foci of susceptibility effect in the bilateral frontal lobes may represent chronic microhemorrhages.4. Mild diffuse cerebral volume loss.