 There is a normal ventricular size. No midline shift. Normal gray and white matter differentiation. No evidence of bleed, mass effect, or edema. Nonspecific nonenhancing punctate foci T2 hyperintensity are noted in the periventricular and subcortical white matter without mass effect, restricted diffusion, susceptibility abnormality, or enhancement.Expected vascular flow-voids are demonstrated. The midline structures and the craniocervical junction are within normal limits.
Nonspecific nonenhancing punctate foci T2 hyperintensity are noted in the periventricular and subcortical white matter, most likely representing chronic small vessel ischemic disease or perhaps migraine headache sequelae. Given lesional location and morphology, demyelination is felt to be unlikely.