Reason: patient with dementia and gait disorder. assess for NPH History: severe gait instability The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.There is a mild degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images. This remains stable compared to the prior exam Patchy T2 and flair signal hyperintensity is also present in the brain stem. This has mildly progressed compared to the prior examOn susceptibility imaging there is a punctate focus of signal hypointensity in the right pons. Most like represents a microhemorrhage. In isolation this is of little clinical significance.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. The eyeball lenses are thin.
1.Periventricular and subcortical white matter and the brainstem changes of a mild degree are nonspecific. At this age they are most likely vascular related. 