 The examination is limited by motion artifact. There is a large area of encephalomalacia and susceptibility artifact present in the right temporal lobe, which is new since August 2014. There is also encephalomalacia and susceptibility effect in the right parietal lobe. There is a diffuse background of high T2 signal involving in the bilateral cerebral white matter. In addition, there are punctate foci of what appears to be restricted diffusion adjacent to the right gyrus rectus right occipital lobe, and left middle frontal gyrus. There are scattered areas of gyriform susceptibility effect along the bilateral upper cerebral hemispheres and multiple peripheral intraparenchymal foci of susceptibility effect. There is no midline shift or mass effect. There is diffuse prominence of the cortical sulci in proportion to the cerebral ventricles consistent with diffuse cerebral atrophy. There is a left lens implant and what may represent choroidal or retinal detachment. There is mild mucosal thickening in the paranasal sinuses.
1. Chronic right temporal and parietal hemorraghic infarcts and a background of probable chronic small vessel ischemic disease, as well as what may represent recent punctate infarcts and/or artifacts adjacent to the right gyrus rectus, right occipital lobe, and left middle frontal gyrus.2. Multiple peripherally located foci of microhemorrhages are suggestive of amyloid angiopathy.3. Diffuse superficial siderosis in the superior bilateral cerebral hemispheres related to chronic subarachnoid hemorrhage.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.