Findings:
Striking volume loss is present in the right temporal lobe, particularly anteriorly with ‘knife-like’ gyri. Also, moderate generalised volume loss is seen.
No intra or extra-axial blood or fluid collection is present. There is no mass or shift of midline.
Confluent zones of decreased attenuation involving the subcortical and periventricular cerebral white matter are noted, in keeping with moderate small vessel ischemic disease.
Small post embolic defects are seen in both cerebellar hemispheres.
No loss of the grey-white matter junction is seen.
Hyperostosis frontalis interna is seen.
Mild mucosal thickening is seen in the right sphenoid sinus. Sclerotic changes of the right mastoid process are seen. No calvarial fracture or suspicious bony abnormality seen.
Impression:
No acute intracranial process.
Striking right temporal atrophy, suspicious of semantic variant of frontotemporal dementia.