69-year-old male to assess for central sleep apnea. Again seen are multiple punctate foci of susceptibility effect scattered in the subcortical white matter of the supratentorial brain as well as multiple foci in the cerebellum. There is also a punctate focus of susceptibility effect that appears to be along the anterior aspect of the medulla and also seen previously. No restricted diffusion to suggest acute ischemia. No intracranial mass or mass-effect. The ventricles are within normal limits in size and configuration. There are a few scattered foci of T2/FLAIR hyperintensity in the periventricular and subcortical white matter, which are nonspecific, but compatible with mild chronic small vessel ischemic changes. These are not significantly changed from the prior examination.Major flow-voids are preserved.Sella and orbits are grossly within normal limits. Paranasal sinuses and mastoid cells are clear. Bone marrow signal and extracranial soft tissues are within normal limits.
1. Multiple scattered foci of susceptibility effect in the bilateral cerebral hemispheres, cerebellum, as well as one in the medulla. Findings are consistent with chronic microhemorrhages and similar to recent MRI from 8/8/2016. Distribution of these microhemorrhages is nonspecific but may be related to amyloid angiopathy and/or chronic hypertension.2. Mild chronic small vessel ischemic changes. 3. Brain parenchyma is otherwise unremarkable with no acute findings.