Severe volume loss involving the anterior temporal lobes and mesial temporal structures, including hippocampal formations and amygdala, is again demonstrated and unaltered, with marked ex-vacuo dilation of the temporal horns. Pronounced involvement of the superior temporal gyri and presence of gliosis are features favouring frontotemporal dementia over Alzheimer's disease. Moderate out of keeping volume loss involving the frontal lobes is also unchanged. Scattered white matter foci of T2 hyperintensity are consistent with chronic microvascular ischaemia, mild for age. No diffusion restriction or parenchymal susceptibility artefact. Unfortunately perfusion studies are severely degraded by artefact and hence are non contributory.
Frontotemporal atrophy, with marked temporal predominance. Appearance is more consistent with frontotemporal dementia than Alzheimer's disease.