Alzheimer versus NPH: memory deficits and wobbly gait. There is mild diffuse cerebral volume loss that is most pronounced in the bilateral medial temporal horns, left more than right. There is scattered cerebral white matter T2 hyperintensity. There is no evidence of intracranial hemorrhage, mass, or acute infarct. 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.
1. Mild diffuse cerebral volume loss that is most pronounced in the bilateral medial temporal horns, left more than right, is suggestive of Alzheimer disease rather than normal pressure hydrocephalus.2. Scattered cerebral white matter lesions likely represent chronic small vessel ischemic disease.3. No evidence of acute intracranial hemorrhage, mass, or acute infarct.