Brief Answer: Please find detailed answer below Detailed Answer: Hi XXXXX, Thanks for writing in. Mild to severe cortical atrophy is seen in most individuals over 60 years of age. The age of the patient is important when discussing atrophy and sometimes atrophy can be an expected finding in the elderly though at times this can cause cognitive and memory deficits with dementia. Small vessel ischemia is a change due to decreased blood flow through some of the vessels supplying the brain. This is usually due to conditions like diabetes, hypertension and also as a part of aging process. Cortical atrophy and small vessel ischemic changes are not too serious but you may have to take medications depending on your clinical symptoms and problems. The words partial opacification and thickening within the left mastoid air cells mean that there is a chance of middle ear infection which might have infiltrated the surrounding mastoid bone. This needs a consultation with an ear nose throat surgeon and if you have mastoiditis as a result of middle ear infection then you must get it treated by medications initially and if there is severe infection a surgery may be needed. This must be treated so that it does not spread to the brain and cause brain infections. Hope your query is answered. Do write back if you have any doubts. Regards, Dr.Vivek

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