### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Hi, I had an MRI last week and I m worried about the results (below). Some of the symptoms that lead to the test include, severe dizziness--2 mos; numbness on the right side of my face--2 mos; poor word recall; severe fatigue; and a general feeling of fogginess. Here are the MRI results: EXAMINATION: MRI Brain without contrast. CLINICAL HISTORY: Right-sided facial numbness COMPARISON: CT head dated 7/24/2014 TECHNIQUE: Multiplanar, multisequence MR imaging of the brain without intravenous contrast was acquired. FINDINGS: The ventricles are of normal size, shape, and contour for the patient s age. There are several (approximately 6-7) scattered punctate foci of T2 FLAIR hyperintensity involving the periventricular and subcortical white matter. The largest is a periventricular focus in the left frontal lobe measuring approximately 4 mm in diameter (axial FLAIR image 22). These foci are nonspecific, and slightly greater than expected for the patient s age. No evidence of acute intracranial hemorrhage, edema, or hydrocephalus. There is no mass effect or midline shift. Diffusion weighted imaging reveals no diffusion restriction to suggest acute infarction. The visualized skull base and calvarium demonstrate no significant abnormality. IMPRESSION: 1. No evidence of an acute intracranial process. 2. Scattered punctate foci of T2 FLAIR hyperintensity involving the periventricular and subcortical white matter. This is a nonspecific finding that can be seen in the setting of chronic microangiopathic change, migraines, demyelinating disease, and various other inflammatory/infectious etiologies. Signed by: Jason Huston, DO HUSTON JASON Dictated By DATE DICTATED: 09/11/2014 DATE TRANSCRIBED: 09/11/2014 TRANSCRIPTIONIST: TECHNOLOGIST: RCB

### output:

Hi, Thanks for writing in. Your MRI scan brain findings are explained below.FINDINGS:1. The ventricles are of normal size, shape, and contour for the patient s age. There are several (approximately 6-7) scattered punctate loci of T2 FLAIR hyperintensity involving the periventricular and subcortical white matter. The largest is a periventricular focus in the left frontal lobe measuring approximately 4 mm in diameter (axial FLAIR image 22). These loci are nonspecific, and slightly greater than expected for the patient s age. This shows possible small vessel disease. It is expected in the elderly age group, but there is a mention that having 6 to 7 such lesions is slightly more than usual. These findings can occur earlier in hypertension and diabetes and if you do not have these conditions, other disease involving cerebral vasculature must be thought of.2. No evidence of acute intracranial hemorrhage, edema, or HY Chat Doctor.  There is no mass effect or midline shift. Diffusion weighted imaging reveals no diffusion restriction to suggest acute infarction. The visualized skull base and calcium demonstrate no significant abnormality. This details that there is no sign of acute stroke like episode and the findings are more of a non stroke origin. In conclusion, the above findings are indicative of microangiopathic changes in small vessels in brain. These are non-specific and can cause symptoms like migraines, vertigo and slight fogginess related problems. A repeat MRI scan brain might be required in 6 months to a year if there is sudden progressive symptoms from the ones you are having. Medications might be given to preserve your brain microangiopathic changes and reduce the symptoms.