Left optic nerve pallor. Orbits: There is diffuse volume loss of the left optic nerve and chiasm without evidence of signal abnormality. There are no compressive mass lesions. There is no evidence of abnormal enhancement. The globes and ocular adnexa are unremarkable.Brain: There is no evidence of intracranial hemorrhage, mass, or acute infarct. There is mild scattered cerebral white matter T2 hyperintensity. There is no abnormal intracranial enhancement. The ventricles are unchanged in size and configuration. There is no midline shift or herniation. Punctate foci of susceptibility effect along the bilateral hippocampi correspond to calcifications. The major cerebral flow voids are intact. There is a 5 mm wide left frontal scalp lipoma. There is mild mucosal thickening in the maxillary sinuses.
1. Diffuse left optic nerve atrophy without evidence of inflammatory neuritis or compressive neuropathy.2. Chronic small vessel ischemic disease, but no evidence of acute intracranial hemorrhage, mass, or cerebral edema.