Vascular dementia

Discussion:

Extensive chronic small vessel ischemic changes is the most striking finding.

Mild parietal volume loss and quite striking anterior hippocampal and temporal lobe atrophy may also suggest co-existing AD. 

Frontal and anterior temporal lobe atrophy raises the possibility of language variant frontotemporal dementia, however, the age and absence of left/right asymmetry makes this unlikely. 

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