 Diffusion images are negative for acute stroke. Again as in the previous study there is demonstration of numerous varying sized foci of increased signal intensity on FLAIR and T2-weighted images in the periventricular and subcortical white matter of the bilateral cerebral hemisphere. High signal is again seen in the bilateral caudate nuclei and basal ganglia.Since the previous study the foci that were seen in the pons are progressed and more conspicuous and currently seen in the right more than the left.The ventricles and sulci are within normal limits. The basal cisterns remain patent. There is no midline shift or mass effect. There is no diffusion abnormality. No extra-axial fluid collection is identified.Empty sella is seen; however, there no other associated MR signs of pseudotumor cerebri.Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits. There is partial opacification of the left ethmoid and the maxillary sinuses bilaterally, left more than the right.
1. There is mild progression of subtle T2 and FLAIR hyperintensity in the right greater than left pons, likely representing chronic small vessel ischemic changes.2. Numerous stable variably sized foci of abnormal signal in the periventricular and subcortical white matter of the bilateral cerebral hemisphere without any abnormality in the posterior fossa. Findings again, may represent chronic small vessel disease or the sequela of SLE.