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Dr. James
Dr. James, Doctor
Category: Medical
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Experience:  Doctor of Medicine
20222826
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I'm a 60 year old male in excellent health. I have never had

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I'm a 60 year old male in excellent health.   I have never had high blood pressure. I do have hereditary peripheral neuropathy--probably Charcot-Marie-Tooth Syndrome.

Two weeks ago, I had my first serious episode with diverticulitis and ended up in the hospital for 3 days to treat the absess & infection. A CT scan of my gut confirmed the diverticulitis. A CT of my head done at the same time noted, "There is diffuse parenchymal volume loss of the brain with mild prominence of the ventricles unchanged. There is very minimal mucosal thickening in the ethmoidal air cells." It also stated the impression of, "diffuse parenchymal volume loss of the brain and chronic small vessel ischemic disease in the paraventricular white matter."

What does all this mean? Should I see my interest or my neurologist?
Submitted: 8 years ago.
Category: Medical
Expert:  Dr. James replied 8 years ago.
Are you having any other symptoms? confusion, weakness, numbness, difficulty with speach, movement?
Customer: replied 8 years ago.
No- I'm a college professor and I have had prostate cancer diagnosed--I'm waiting for the prostate removal surgery at the Mayo Clinic. I have no "confusion, weakness, numbness, difficulty with speach, movement". I am, of course, concerned that the physical finding indicates the early onset of dimensia, alsheimers, etc. I guess it would be better to know than not to know. Thanks for your time and your expertise.
Expert:  Dr. James replied 8 years ago.
The findings that you described are commonly seen with aging. A person can lose brain volume as he/she ages and so it is not uncommon to see this kind of finding on CT scan. The "minimal mucosal thickening in the ethmoidal air cells" might indicate a bit of sinus disease/allergies, but are not significant if you are not having any problems.

The "chronic small vessel ischemic changes" are areas in the small vessels of your brain that had a lack of blood flow at some point in time. Unless associated with any symptoms (confusion, weakness, numbness, difficulty with speech), then there is no need to be alarmed.

The findings on your CT scan are nonspecific and can not diagnose you with Alzheimers or dementia, espeically since you are not having any clinical signs of dementia (memory loss, confusion, abnormal forgetfullness, etc) from what you are describing.

You should bring this report to your primary care doctor so that he can be aware and keep a copy on your file. There is no need for a neurologist at this time. This CT scan is important as a baseline and allows for comparison in the future if you so happen to get another CT scan for any relevant problems.

Best wishes,
Dr. JMK
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