Transient unresponsiveness. MRI: There is no evidence of intracranial hemorrhage, mass, or acute infarct. There is a small focus of encephalomalacia in the left pons. There is also a background of scattered cerebral white matter T2 hyperintensity, particularly in a periventricular distribution. There is disproportionate volume loss involving the bilateral medial temporal lobes. 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.MRA: There is no evidence of significant steno-occlusive lesions or aneurysms.
1. Chronic lacunar infarct in the left pons and probable chronic small vessel ischemic white matter disease, but no evidence of acute infarct.2. Disproportionate volume loss involving the bilateral medial temporal lobes can be manifestation of Alzheimer disease.3. No evidence of significant steno-occlusive lesions or aneurysms.