42-year-old male with altered mental status and lethargy There is no evidence of intracranial hemorrhage, mass or edema. Encephalomalacia involving bilateral frontal lobes and bilateral temporal lobes are again noted and not significantly changed from comparison MRI accounting for technical differences. Otherwise symmetric prominence of a ventricular system is in proportion to the diffuse sulcal prominence compatible with generalized brain atrophy. Slight hyperdense lesion extending from the left basal ganglia into the left cerebral peduncle that corresponds to high T1 signal lesion on prior MR is of uncertain clinical etiology and significance.Basal ganglia and right insula calcifications have increased in size, but were likely present on prior MRI. There are atherosclerotic calcifications of the basilar artery as well as bilateral internal carotid arteries and middle cerebral arteries.Hyperostosis frontalis is noted. Otherwise, the calvaria and skull base are radiographically normal. The visualized paranasal sinuses and mastoid air cells are normally pneumatized.
Accounting for technical differences, there is no significant change compared to prior MRI as described above. Due to multiple abnormalities correlation with MRI should be considered for more definitive comparison.