Alzheimer versus multiple sclerosis versus depression: memory problems dating for 3 years, MOCA of 8. There is no evidence of intracranial hemorrhage, mass, or acute infarct. There is slight interval increase in the extent of the scattered cerebral and pontine white matter T2 hyperintense lesions. There has also been interval increased prominence of the ventricles, particularly the lateral and third ventricles, as well as the sulci. There is a prominent jet of cerebrospinal fluid flow in the third ventricle. There is no midline shift or herniation. The major cerebral flow voids are intact. The skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable. There is mild staphylomatous deformity of the globes.
1. Slight interval increase in the extent of the scattered supratentorial and infratentorial white matter T2 hyperintense lesions, which may represent chronic small vessel ischemic disease, perhaps superimposed on demyelinating lesions.2. Interval increased prominence of the ventricles, particularly the lateral and third ventricles, as well as the sulci, which may be due to cerebral volume loss, although a superimposed component of normal pressure hydrocephalus is a consideration. 3. No evidence of acute intracranial hemorrhage, mass, or acute infarct.