Diagnosis: Alzheimer's disease Dementia in conditions classified elsewhere without behavioral disturbance. Vascular dementia, uncomplicatedClinical question: cognitive declineSigns and Symptoms: memory loss The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.There is a moderate degree of periventricular and subcortical confluent hyperintense white matter lesions present identified on the FLAIR and T2 images. Additionally multiple signal hyperintensities are also present in the brainstem and deep gray nuclei and internal capsules as well as the cerebellar hemispheres.There are punctate foci of signal loss present in the brainstem, left cerebellar hemisphere , bilateral thalami left medial temporal lobe, left and right inferior temporal gyrus and frontal lobes and parietal lobes bilaterally.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 are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits demonstrate subchoroidal fluid along the right eye.
1.There are periventricular, subcortical white matter, internal capsule, deep gray nuclei and brainstem signal changes present. These are nonspecific and could be vascular related. This could also relate to a neurodegenerative process such as nonspecific leukoencephalopathy of aging or represent a mixed pattern.2.There are multiple microhemorrhages present within the brain. This appears to be a mixed pattern without predominantly a hypertensive pattern. A superimposed less prevalent secondary pattern with subcortical and cortical microhemorrhages resulting for example from amyloid angiopathy cannot be excluded.