New onset headache and dizziness. There is no evidence of intracranial hemorrhage, mass, or acute infarct. There is confluent periventricular white matter T2 hyperintensity and a few scattered deep white matter T2 hyperintensity foci. There is no abnormal intracranial enhancement. There is perhaps mild diffuse cerebral volume loss. There is a mega cisterna magna. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, and scalp soft tissues are grossly unremarkable. There are scattered paranasal sinus small retentions cysts, including adjacent to the left nasolacrimal duct.
Perhaps mild diffuse cerebral volume loss and nonspecific areas of cerebral white matter signal abnormality may represent chronic small vessel ischemic disease, for example. Otherwise, no evidence of intracranial hemorrhage, mass, or acute infarct. 