Male, 78 years old, with history of multiple sclerosis, right hand tingling, memory loss, balance issues. No restricted diffusion is seen. Moderate scattered foci of periventricular and subcortical white matter T2 hyperintensity are noted. No evidence of edema or mass effect is detected. No acute intracranial hemorrhage or any abnormal extra-axial fluid collection is seen. Prominence of the sulci and ventricles is demonstrated compatible with underlying parenchymal volume loss. Of note, the temporal horns are of particular prominence which may reflect preferential medial temporal lobe atrophy. On limited postcontrast imaging, no enhancing lesions are seen.
1.No definite acute intracranial abnormality is seen.2.Scattered white matter lesions are noted which may represent chronic microvascular ischemic disease or, given the history, demyelinating disease.3.Generalized cerebral atrophy is seen, though this appears to be particularly conspicuous in the medial temporal lobes. Correlation with clinical features of Alzheimer disease should be made.