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: 0 – no cortical atrophy.
Koedam score for parietal atrophy: 0 – no atrophy.
Mesial Temporal Atrophy: 0 – no atrophy.
Confluent zones of decreased attenuation involving the subcortical and periventricular cerebral white matter are noted, in keeping with Fazekas scale 3.
Elongated and ectatic basilar artery with prominent co-dominant vertebral arteries. The basilar artery measures up to 6 mm in diameter.
Its tip and bifurcation point rise above the suprasellar cistern, abutting the floor of the 3rd ventricle. There is no secondary obstructive hydrocephalus.
The orbits have a normal appearance and the visualized paranasal sinuses and mastoid air cells are clear.
No bony abnormality is seen.
Impression:
No significant involutional changes.
Advanced small vessel ischaemic disease (Fazekas scale 3), supportive of the diagnosis of vascular dementia.
Vertebrobasilar dolichoectasia.