54 years, Female, alcohol abuse and new altered mental status 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 chronic small vessel ischemic disease. No restricted diffusion to suggest acute ischemia. No intracranial mass or mass-effect. There is global parenchymal volume loss which is slightly advanced for patient's age. Few foci of susceptibility are seen involving the left greater than right basal ganglia which may related to mineralization. No hydrocephalus. No extra-axial collections. Major flow-voids are preserved. Minimal mucosal thickening is seen in the paranasal sinuses which are otherwise clear. There is also mild opacification of the bilateral mastoid air cells. There is diffuse heterogeneity of the bone marrow signal without discrete destructive osseous lesions evident.
1. No evidence of acute infarct, hemorrhage, or intracranial mass effect.2. Mild to moderate chronic small vessel ischemic changes. 3. Global parenchymal volume loss which appears slightly advanced for age.4. Diffuse heterogeneity of the bone marrow signal is nonspecific. No discrete destructive osseous lesion is evident.