79 year old male with language disorder and mild cognitive decline No evidence of restricted diffusion to suggest acute ischemia or infarction. Redemonstrated are primarily periventricular foci of T2/FLAIR hyperintensity without associated mass effect, restricted diffusion, susceptibility abnormality, or enhancement. Also redemonstrated is a punctate focus of increased T2/FLAIR hyperintensity in the right thalamus, which appears similar to the prior study and consistent with a remote lacunar infarction. The ventricles and sulci are slightly prominent, however unchanged. There is no evidence of pathologic intracranial enhancement. The visualized paranasal sinuses are aerated. Bilateral orbital contents are unremarkable. Proximal intracranial flow voids are identified apart from loss of the signal void in the distal left vertebral artery.
1.No acute ischemia or infarction. No pathologic intracranial enhancement.2.Loss of the signal void in the distal left vertebral artery is again noted.3.Stable chronic small vessel ischemic disease.