Altered mental status. MRI: There is diffuse cerebral and pontine white matter T2 hyperintensity and punctate foci of encephalomalacia in the bilateral basal ganglia without restricted diffusion. There is no evidence of intracranial hemorrhage, mass, or acute infarct. The ventricles and basal cisterns are unchanged in size and configuration. 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 is a retention cyst in the right maxillary sinus. There is unchanged anterior dislocation of the left mandibular condyle.MRA: There is no evidence of significant steno-occlusive lesions or saccular aneurysms.
1. Chronic small vessel ischemic white matter disease and chronic basal ganglia lacunar infarcts, but no evidence of acute intracranial hemorrhage, mass, or acute infarct.2. No evidence of significant steno-occlusive lesions.