Left parotid gland lesion. Dementia. There are multiple lesions present involving gray and white matter scattered in both hemispheres of the supratentorial brain but in asymmetric locations. Some are located along the medial aspects of the frontal lobes, the insular cortex bilaterally as well as a lesser degree the lateral aspects of the frontal and parietal lobes and temporal lobes. These are best appreciated on the FLAIR MRI images. There is no associated contrast enhancement. There is no associated susceptibility effect with these lesions. There is associated vasogenic edema on some of these lesions. There may be a small amount of diffusion restriction associated with these. There is no involvement of the thalami.There is a mild degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images.Postcontrast imaging is degraded by patient motion which may obscure more subtle abnormalities.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 mild mucosal thickening in the left maxillary sinus. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.There is a small cystic lesion present in the right parotid gland measuring 7 mm in diameter. It is not entirely included on this exam.
1.There are multiple lesions scattered throughout the cortex of the supratentorial brain. Differential considerations include Creutzfeldt-Jakob disease, encephalitis due to another cause, paraneoplastic encephalitis and hypoglycemic encephalopathy.2.There is a mild degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images.3.Postcontrast imaging is degraded by patient motion which may obscure more subtle abnormalities.4.There is a small peripherally based lesion in the right parotid gland which is not entirely included on this exam. It is nonspecific