Memory loss. Many of the sequences are degraded by patient motion. There is moderate diffuse cerebral white matter T2 hyperintensity and left basal ganglia encephalomalacia with susceptibility effect. There is also right occipital lobe encephalomalacia. There is no evidence of intracranial hemorrhage, mass, or acute infarct. There is diffuse cerebral volume loss, which is particularly pronounced in the medial temporal lobes bilaterally. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable. There is a small atlanto-axial articulation effusion.
1. Diffuse cerebral volume loss, which is particularly pronounced in the medial temporal lobes bilaterally may be a manifestation of Alzheimer's disease. 2. Moderate diffuse chronic small vessel ischemic disease and chronic right occipital lobe infarct and left basal ganglia hemorrhagic lacunar infarct, but no evidence of acute intracranial hemorrhage, mass, or acute infarct.