Findings:
No intra- or extra-axial mass lesion or collection is identified. The midline structures are normal with no midline shift.
Large postischaemic area of encephalomalacia is seen in the left cerebellar hemisphere. Further, small area of encephalomalacia is seen in territory of the right PCA in the right occipital lobe.
The sulci and ventricles are mildly more prominent than expected for age. The mesiotemporal structures, including the temporal horns of the lateral ventricles and the collateral sulci, are slightly more prominent, with bilateral hippocampus and amygdala reduced in volume (MTA score 3). Additionally, prominent atrophy of the parietal lobes is seen, more significant on the right side (Koedam 2-3).
Mild background small vessel ischaemic disease (Fazekas 1).
The orbits have a normal appearance and the paranasal sinuses and mastoid air cells are clear.
No bony abnormality is seen.
Conclusion:
Bilateral parietal and mesiotemporal atrophy, suspicious of Alzheimer disease or limbic-predominant age-related TDP-43 encephalopathy (LATE).
Large, chronic left cerebellar infarct as well as small right occipital infarct.