 There are innumerable punctate foci of enhancement throughout the supratentorial as well as infratentorial brain, some of which have associated T2 hyperintensity. None of which demonstrate mass effect or associated susceptibility abnormality. There are other foci of T2 hyperintensity are present throughout the white matter, primarily subcortical in location, none of which restrict nor have associated susceptibility abnormality. Redemonstrated is mild diffuse volume loss without a specific lobar predominant atrophy pattern. The cerebellar tonsils are in normal position. There are no masses, mass effect or midline shift. 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. Opacification is noted of aright posterior ethmoid air cell. The mastoid air cells are clear. There is no abnormal enhancement within the brain.
1.There are innumerable punctate foci of enhancement throughout the supratentorial as well as infratentorial brain, some of which have associated T2 hyperintensity. None of which demonstrate mass effect or associated susceptibility abnormality. These findings are most consistent with metastatic disease.2.Mild chronic small vessel ischemic disease.