74-year-old female with history of memory loss and left sided signs. There is marked periventricular and subcortical white matter increased T2/FLAIR signal abnormality extending into the pons, which is nonspecific. There are no definite areas of restricted diffusion to suggest acute ischemic infarction. Increased T2 signal is present within the pons and medulla, with correlating T2 shine through on the DWI images. There is no evidence of acute intracranial hemorrhage. There is moderate volume loss which may be age related. Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus. There is a small amount of debris/mucocele within the left frontal sinus. Otherwise, the visualized portions of the paranasal sinuses, mastoid air cells and orbits are unremarkable.
Marked periventricular and subcortical white matter increased T2/FLAIR signal abnormality extending into the brainstem which is nonspecific, but may be the sequela of chronic small vascular ischemic disease.