Former football player with multiple concussions and memory issues, evaluate for structural changes. There is no evidence of acute intracranial hemorrhage, mass, or acute infarct. There are scattered punctate foci and confluent areas of abnormal T2/FLAIR hyperintensity within the periventricular and subcortical white matter, predominantly in the right posterior frontal corona radiata and in the pons consistent with moderate chronic small vessel ischemic changes. There is a focus of susceptibility measuring approximately 4 mm in maximum diameter along the left lateral aspect of the inferior medulla consistent with chronic hemorrhage and nonspecific. The ventricles and basal cisterns are prominent, compatible with mild global parenchymal volume loss which is appropriate for patient's age. There is no midline shift or herniation. There is prominent mineralization involving the basal ganglia which is of uncertain significance in this age group. The major cerebral flow voids are intact. There is mild diffuse paranasal mucosal thickening . The orbits, skull, and scalp soft tissues are grossly unremarkable.
1. Moderate chronic small vessel ischemic disease.2. Focus of chronic microhemorrhage in the left lateral medulla which is nonspecific in etiology. No other areas of hemorrhage or traumatic encephalomalacia.3. Mild global parenchymal volume loss which appears age-appropriate.