 The ventricles and sulci are normal in size. The cerebellar tonsils are in normal position. There are no masses, mass effect or midline shift. There are numerous bilateral foci of T2/FLAIR hyperintensity in the subcortical and periventricular white matter as well as in the bilateral basal ganglia and left cerebellum, suggestive of moderate age-indeterminate small vessel ischemic disease, appearing similar to slightly increased compared to prior examination. The pituitary gland is normal in size. There is no evidence for intracranial hemorrhage or acute cerebral, brainstem or cerebellar infarction. No diffusion-weighted abnormalities are identified. There are no extraaxial fluid collections or subdural hematomas. Flow voids are present within the major vessels indicating patency. The paranasal sinuses and mastoid air cells are clear. There is no abnormal enhancement within the brain.
1.No evidence of intracranial metastases.2.Moderate age-indeterminate small vessel ischemic disease appears similar to slightly increased compared to prior examination.