44-year-old female with altered mental status. Evaluate for stroke or PRES. Images are somewhat limited by patient motion. There are several oval foci of T2/FLAIR hyperintensity in the cerebral white-matter, which appear perpendicular to the long axis of the lateral ventricles. These are most conspicuous along the right lateral ventricular margin. Allowing for differences in technique, these have not appreciably changed since prior exams, allowing for differences in technique. There is no abnormal restricted diffusion.There are multiple foci of punctate susceptibility artifact in the cerebrum and cerebellum without associated edema, reflecting chronic microhemorrhages. There is no mass-effect, midline shift or brain herniation. The ventricles, sulci and basal cisterns are mildly to moderately enlarged relating to global volume loss greater than expected for patient's stated age. The major intracranial vascular flow voids are preserved.There are mucous retention cysts in the maxillary sinuses.
1. Continued stable appearance of scattered nonspecific white matter lesions with unchanged differential.2. Persistent global volume loss greater than expected for patient's stated age.