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Non specific high T2 signal foci are noted in the white matter slightly more than expected for age and likely due to chronic small vessel ischaemia, but probably insufficient to explain cognitive decline. The left hippocampal formation is mildly decreased in size. The temporal horn of the lateral ventricle on this side is not particularly dilated but there is volume loss in the parahippocampal white matter. No asymmetrical cortical atrophy. No cortical or basal ganglia diffusion restriction.
No significant intracranial stenosis on the MRA images.
Impression: Mild atrophy of the left hippocampal formation with associated volume loss in the medial temporal lobe. This could reflect early Alzheimer's dementia but as this is only mild progress imaging in a year is recommended. Alternatively a SPECT might assist.