Altered mental status. The images are generally degraded by patient motion. There is no evidence of intracranial hemorrhage, mass, or acute infarct. There is extensive cerebral white matter T2 hyperintensity, predominantly in a periventricular distribution, but also in the pons. There is diffuse cerebral volume loss. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, and scalp soft tissues are grossly unremarkable. There are bilateral maxillary sinus retention cysts. There is a right cheek lipoma that measures up to 15 mm. There is incomplete fusion of the anterior and posterior arches of C1.
Extensive probable chronic small vessel ischemic disease, but no evidence of acute intracranial hemorrhage, mass, or acute infarct.