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Alzheimer’s disease or limbic-predominant age-related TDP-43 encephalopathy (LATE)

Findings:
No intra- or extra-axial mass lesion or collection is identified. The midline structures are normal with no midline shift.
No sign of atrophy of the midbrain or the cerebellum.
Global cortical atrophy score. 2 – volume loss of gyri and moderate ventricular enlargement.
Koedam score for parietal atrophy: 1 on the right side and 2 on the left – mild to moderate sulcal widening and gyral atrophy
Mesial Temporal Atrophy: 3 – marked widening of the choroid fissure, moderate enlargement of the temporal horn, and moderate loss of hippocampal height.
Moderate background small vessel ischaemic disease (Fazekas 2).
Embolic areas of encephalomalacia are noted in the right cerebellar hemisphere. No acute ischaemic event or intracranial haemorrhage.
The imaged paranasal sinuses and mastoid air cells are clear. IOL-implants are noted bilaterally.
No bony abnormality is seen.

Conclusion:
Findings are suspicious of Alzheimer’s disease or limbic-predominant age-related TDP-43 encephalopathy (LATE).
Moderate small vessel ischaemic disease (Fazekas 2).
Post embolic areas of encephalomalacia in the right cerebellar hemisphere.

Updated on 18. May 2023

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About the author

Dr Sara Mohebbi is a Consultant Radiologist (Facharzt für Radiologie) with sub-specialty training in neuroradiology. She served as Chief Resident at University Hospital Freiburg and is a member of the European Society of Radiology (ESR). Her clinical focus includes demyelinating disease, neuro-oncology, and vascular neuroimaging. Dr Mohebbi is the Clinical Lead at Radiology Prime, where she provides independent second opinion reports on brain and spine MRI.