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Focus of cortical loss and subjacent subcortical T2 hyperintensity in the left superior and middle frontal gyrus. In the left centrum semiovale, corona radiata and mid body of corpus callosum deep to this region there are several small foci of diffusion restriction. These were present on the previous MRI from 3 October, 2013 (not shown). No associated contrast enhancement or foci of susceptibility artefact..
Scattered periventricular, deep and subcortical T2 hyperintense foci elsewhere in cerebral white matter are unchanged. These are in excess of expected lesion number for age. Punctate focus of susceptibility artefact in the left anterior temporal lobe and in the left parietal lobe, one in the right temporal lobe and several in the inferior frontal lobes are present, typical of microhemorrhages secondary to cerebral amyloid angiopathy.
No pathological contrast enhancement. No mass lesion identified. Normal MRA (not shown). Foetal supply of the posterior cerebral arteries is incidentally noted.
Cerebral amyloid angiopathy, with superimposed left frontal encephalomalacic insult. Presence of restricted diffusion is of uncertain significance. CAA related inflammation / vasculitis is a possibility.
Catheter angiography (not shown): There is no angiographic abnormality.In particular, there is no evidence of vasculitis.