My father had a CT scan and impressions read moderate-grade supratentorial proportional atrophy with white matter chronic gliotic changes. Probably and most commonly as a result of chronic small vessel ischemic disease, thrombotic microangiopathy . Is this supportive of vascular dementia dx? His internist told us he has cognitive dementia and put him on Aracept for one month then pulled him off when Dad & Mom noted no change. Internist will not advocate for Dad to seek out speicalist (i.e. neurologist/Frontotemporal Disease specialist), nor will he order an MRI to make clear dx. We are very confused about what exactly is going on.