72-year-old male with new onset tremor and gait disorder, concern for atherosclerotic Parkinson's disease. No restricted diffusion to suggest acute ischemia. No intracranial hemorrhage. No intracranial mass or mass-effect. There is diffuse prominence of the ventricles and sulci indicating mild global atrophy.Several foci of T2/FLAIR hyperintensity are seen in the bilateral subcortical and periventricular white matter, which are nonspecific, but compatible with chronic small vessel ischemic changes. Normal flow-voids are demonstrated in the major intracranial vascular structures.The sella and orbits appear within normal limits. There is partial opacification of the right posterior ethmoidal air cells, right frontal sinus as well as the right mastoid air cells. Chronic appearing opacification of the right sphenoid sinus. Bone marrow signal and extracranial soft tissues are within normal limits.
.1. Mild chronic small vessel ischemic disease involving the periventricular and subcortical white matter.2. Prominence of the ventricles and sulci compatible with mild global atrophy. 3. Chronic appearing paranasal sinus disease as described above.