Abnormal focal finding on EEG and altered mental status. There is no evidence of acute intracranial hemorrhage, mass, or acute infarct. There are scattered patchy and punctate areas of high T2 signal in the cerebral white matter, without restricted diffusion. There are multiple punctate foci of susceptibility effect in the bilateral basal ganglia and thalami. The brainstem and cerebellum appear unremarkable. There is no abnormal intracranial enhancement. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, paranasal sinuses, and scalp soft tissues are grossly unremarkable. There is a T1 hypointense, enhancing area in the right parietal bone, which measures up to 25 mm.
1. No evidence of acute intracranial hemorrhage, mass, or acute infarct. 2. Scattered patchy and punctate areas of high T2 signal in the cerebral white matter may represent chronic small vessel ischemic disease.3. Multiple punctate foci of susceptibility effect in the bilateral basal ganglia and thalami may represent chronic hypertensive microhemorrhages.4. Nonspecific enhancing area in the right parietal bone, which measures up to 25 mm. Differential considerations include an atypical hemangioma, venous lake, and metastatic disease, for example.