63 years, Female, seizures, rule out structural lesion. There is no restricted diffusion to suggest acute ischemia. No intracranial mass or mass-effect. The ventricles are within normal limits in size and configuration. There are multiple foci of susceptibility consistent with chronic microhemorrhage including the bilateral thalami, pons, and bilateral cerebellar hemispheres. Multiple foci of chronic microhemorrhage are also seen in the peripheral lobar distribution. Slightly larger area of susceptibility is seen involving the right thalamus likely related to chronic hemorrhage.There are patchy areas and scattered foci of T2/FLAIR hyperintensity in the bilateral subcortical and periventricular white matter, which are nonspecific, but compatible with moderate chronic small vessel ischemic changes. More focal areas of volume loss are seen including the bilateral corona radiata, left thalamus, and bilateral cerebellar hemispheres consistent with chronic infarcts. No abnormal parenchymal or meningeal enhancement. Major flow-voids are preserved. Bone marrow signal and extracranial soft tissues are within normal limits.
1. No evidence of acute infarct, intracranial mass or mass effect.2. Moderate chronic small vessel ischemic disease with multiple small infarcts including the corona radiata, left thalamus, and bilateral cerebellar hemispheres. There also multiple foci of chronic microhemorrhage with a distribution compatible with chronic hypertension and/or amyloid angiopathy. There is a relatively larger focus of chronic hemorrhage involving the right thalamus. 