Parkinsonian gait with bradykinesia but no rigidity. Evaluate for structural abnormality. The ventricles and sulci are prominent, consistent with global parenchymal volume loss. The basal cisterns remain patent. There is no midline shift or mass effect. There are scattered punctate foci and confluent areas of abnormal T2/FLAIR hyperintensity within the periventricular and subcortical white matter, consistent with chronic small vessel ischemic changes. There is no diffusion abnormality. No extra-axial fluid collection is identified. There is a partially empty sella. There is a small mucous retention cyst in the right maxillary sinus.Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits.
1. Global parenchymal volume loss and chronic small vessel ischemic changes. 2. No evidence of intracranial hemorrhage, mass effect, or acute infarct.