Dementia, unspecified, without behavioral disturbance. Other speech disturbance MRI of the brainNo diffusion weighted abnormalities are appreciated.The CSF spaces are appropriate for the patient's stated age with no midline shift. There is a cystic lesion present crossing the left foramen ovale which is unchanged since the prior exam. It has not changed since the prior examNo intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.There is a mild degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images.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 are intact. The left eyeball lens is thin.MRA brain:Antegrade flow is present in the distal internal carotid arteries, the distal vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries.There is no evidence for intracranial aneurysm or cerebrovascular occlusion.The anterior communicating artery is identified. The posterior communicating arteries are small. The vertebral arteries are mildly asymmetric - left larger than right.
1.No evidence for cerebrovascular occlusive disease.2.No evidence for intracranial aneurysm.3.A cystic lesion coursing through the left foramen ovale is unchanged compared to the prior exam. It is contiguous with the left temporal lobe and most likely represents an encephalocele.4.No evidence for acute ischemic cerebral infarction.5.Periventricular and subcortical white matter changes of a mild degree are nonspecific. At this age they are most likely vascular related. 