77-year-old woman with history of left lower extremity ataxia. MRI: There is no evidence of intracranial hemorrhage, mass, or acute infarct. There are unchanged clusters of fluid signal in the inferior basal ganglia bilaterally. There are also scattered foci of cerebral white matter T2 hyperintensity bilaterally. There is mild diffuse cerebral and cerebellar volume loss. There are scattered, punctate foci of susceptibility artifact, which likely represent hemosiderin deposition or mineralization from prior microhemorrhages. There is no midline shift or herniation. There are postoperative findings in the left frontal sinus with osteoplastic flap and trapped secretions. There are lens implants bilaterally. MRA: There is no evidence of significant steno-occlusive lesions. There is no evidence of cerebral aneurysms or vascular malformations.
1.No evidence of acute cerebral infarct or hemorrhage.2.Diffuse cerebral white matter T2 hyperintensity may represent chronic small vessel ischemia. Otherwise, unchanged clusters of fluid signal in the inferior basal ganglia bilaterally likely represent prominent perivascular spaces. 3.No evidence of significant cerebral artery steno-occlusive lesions.