80-year-old male presents with insidious cognitive impairment. There appears to be diffuse cerebral volume loss, which is perhaps most pronounced in the bilateral medial temporal lobes. There is no evidence of intracranial hemorrhage, mass, or acute infarct. There is minimal amount of periventricular cerebral white matter T2 hyperintensity. There is no abnormal intracranial enhancement. There is no midline shift or herniation. The major cerebral flow voids are intact. Mild mucosal thickening in the paranasal sinuses. The skull, and scalp soft tissues are grossly unremarkable. There are bilateral lens implants.
1. Apparent diffuse cerebral volume loss, which is perhaps most pronounced in the bilateral medial temporal lobes. This may indicate the possibility of Alzheimer dementia. A PET scan may be useful for further evaluation.2. Minimal amount of periventricular cerebral white matter T2 hyperintensity is nonspecific, but may reflect chronic small vessel ischemic changes.3. Mild mucosal thickening in the paranasal sinuses.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.