I will interpret each point for you. 1. There is nothing of an IMMEDIATELY SIGNIFICANT nature such as stroke, aneurysm, tumor, or bleed to worry about. 2. There is brain shrinkage in the areas of the brain that are named the TEMPORAL AND PARIETAL lobes which seem to be greater than other parts of the brain. This is sometimes taken as a radiographic sign that can be CORRELATED to the presence of type of dementia such as ALZHEIMER S disease. 3. Mild changes in the smallest vessels of the brain which usually are due to aging processes but in some people who have a history of HYPERTENSION, DIABETES, HIGH CHOLESTEROL, OR WHO ARE SMOKERS, etc. we can see such changes. These are generally insignificant to most clinical problems and presentations. 4. Chronic left sinusitis compared to right side. These are generally irrelevant findings which radiologists almost always make but which almost NEVER have meaning to neurologists who are getting MRI scans on people for neurological problems. There is no way for an MRI (or any type of scan) to DIAGNOSE ALZHEIMERS s. The radiologist is making the call that there is brain shrinkage in areas that are frequently said to be involved in the process of Alzheimer s but the final call of whether he has the beginnings of Alzheimer s or not rests with the NEUROLOGIST who is evaluating him for his cognitive function. If you would like to continue this conversation with more detailed information as to his clinical presentation and how things have been evolving along with lab reports and bloodwork I d be happy to give you more opinions. However, what I ve written is what the MRI says in nonmedical terms. Again, It DOES NOT SAY that he has any type of DEMENTIA....nor should it..... but the Neurologist is in the position to say Yah or Nay to that question. Please rate this a 5 STAR encounter.