Seizure. There is no evidence of intracranial hemorrhage, mass, or acute infarct. There are small areas of encephalomalacia in the right pons, right basal ganglia, and left thalamus. There are several scattered foci of cerebral white matter T2 hyperintensity bilaterally. There is bilateral basal ganglia mineralization. Otherwise, the hippocampi appear to be unremarkable and there is no evidence of heterotopia or hamartomas. There is no abnormal intracranial enhancement. There is mild diffuse cerebral volume loss, with superimposed ex vacuo dilatation of the right anterior lateral ventricle. There is no midline shift or herniation. The major cerebral flow voids are intact. The skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable. There are bilateral lens implants.
Multiple chronic lacunar infarcts in the right pons, right basal ganglia, and left thalamus, superimposed upon mild chronic small vessel ischemic white matter disease, but no evidence of acute infarction or other evidence of potential seizure foci.