Female, 65 years old, with imbalance and question of midline lesion seen on prior exam. The cerebellar fissures are more prominent than what is typically seen suggesting underlying parenchymal volume loss, similar to the prior examination. Pacchionian granulations are evident along the right occipital bone.A focus of encephalomalacia is evident within the posterior right cingulate gyrus, again appearing similar to the prior exam. No other parenchymal signal abnormality is seen. There is no evidence of edema or mass effect. The pattern of intracranial enhancement is within normal limits.No abnormal extra-axial collection or intracranial hemorrhage is seen. The ventricular system is normal in size and morphology.
1.Moderate cerebellar atrophy is seen, similar to that noted on the prior examination from 2007. This finding caries a broad differential diagnosis including sequelae of prior infection/inflammation, effect of certain medications and toxic exposures, and inherited syndromes.2.A small focus of chronic encephalomalacia is evident within the posterior right cingulate gyrus, also unchanged. The etiology for this finding is uncertain.3.No acute intracranial abnormality or other significant intracranial findings are seen. In particular, no evidence of any midline lesion is detected.