I am a 65 yo white male, 5'10", 230lbs. I had what appeared to be a TIA last April. Went to the ER and was fine within about an hour. The neurologist who happened to be in the ER believes it was caused by sleep apnea, and prescribed weight loss, Elloquis and a CPAP device. I have lost 25lbsand have followed his advice. I just had occasion to see the CT report which I have copied below. My doctor has not mentioned anything regarding the report and doesn't seem unduly alarmed, but I am concerned about the mention of "cerebral atrophy" and "small round hypodensity", etc. In your opinion are these changes typical for someone my age, are they signs a past issue, or are they in any way indicative of early dementia?
Study Performed: CT Head Stroke Protocol W/O Contrast
Clinical History: Stroke Symptoms
Comparison: None.
Technique: Contiguous axial images obtained without IV contrast and
reconstructed in the axial plane. Dose reduction techniques were
utilized.
Findings:
Intracranial structures/Brain:
There are distal vertebral and cavernous carotid artery calcifications
present bilaterally.
Mild diffuse bilateral cerebral atrophy. Ventricular caliber
proportionate to cerebral atrophy.
Moderate to marked diffuse low attenuation in the cerebral white matter
bilaterally, nonspecific, most compatible with chronic microvascular
ischemia.
Small round hypodensity in the RIGHT corona radiata (image 34 series
201), isodense to the remaining white matter abnormality.
No acute intracranial hemorrhage.
There is no midline shift.
No ventriculomegaly.
Extracranial soft tissues: unremarkable.
Paranasal sinuses: Mild bilateral ethmoid and RIGHT sphenoid sinus
mucosal thickening.
Mastoids and Middle Ears: Aerated as far as imaged.
Bones: Deviated nasal septum.
Impression:
1. No acute abnormality in the brain.
2. Diffuse low attenuation in the cerebral white matter bilaterally,
typical of chronic small vessel ischemic disease in this patient's age
group.
3. Mild bilateral paranasal sinus mucosal thickening.