 A few sequences are motion degraded. Given this caveat:There are new small focal parenchymal defects within the basal ganglia, as well as inferior right cerebellar hemisphere, with central CSF intensity. There are progressive patchy foci of T2 hyperintensity within the white matter, predominantly periventricular in location, without associated mass effect, restricted diffusion, susceptibility abnormality, or enhancement. The ventricles and sulci are unchanged. The cerebellar tonsils are in normal position. There are no masses, mass effect or midline shift. The pituitary gland is normal in size. There is no evidence for acute intracranial hemorrhage or acute cerebral, brainstem or cerebellar infarction. No diffusion-weighted abnormalities are identified. There are no extraaxial fluid collections or subdural hematomas. Flow voids are present within the major vessels indicating patency. Scattered foci of mucosal thickening can be found within the paranasal sinuses. The mastoid air cells are clear. There is no abnormal enhancement within the brain.
1.Small bilateral basal ganglia lacunar infarcts and inferior right cerebellar hemisphere small vessel infarct. These are new since the 2009 comparison study, however are chronic in appearance.2.Progressive chronic small vessel ischemic disease.