Cognitive impairment. Evaluate for progressive dementia. The ventricles and sulci are prominent, consistent with global parenchymal volume loss, which is progressed from 1/17/2013 and greater than expected for age. The basal cisterns remain patent. There is no midline shift or mass effect. There are scattered foci of abnormal T2/FLAIR hyperintensity within the periventricular and subcortical white matter, consistent with minimal chronic small vessel ischemic changes, which is progressed from 1/17/2013. There is no diffusion abnormality. No extra-axial fluid collection is identified.Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits.
1. Moderate global parenchymal volume loss, which is progressed from 1/17/2013 and greater than expected for age. 2. No acute intracranial hemorrhage or mass effect. Minimal chronic small vessel ischemic changes. 