Alcohol related vermian atrophy
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Headaches. Known alcohol abuse.
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FLAIR hyperintensities scattered throughout the periventricular and subcortical white matter likely reflect chronic small vessel ischemia, of a degree which is prominent for age. The degree of cerebral and cerebellar volume loss is also mildly prominent for age and shows no lobar predilection. The superior cerebellar vermian volume is decreased even allowing for the presence of a prominent cisterna magna (of doubtful clinical significance). There is no hydrocephalus.
No abnormal diffusion restriction, magnetic susceptibility or perfusion is appreciated.
Chronic small vessel ischemic changes and cerebral volume loss are mildly prominent for age, the latter in keeping with history of alcohol abuse.
Vermian atrophy is a typical feature of chronic alcohol excess.