 There are a few punctate foci of T2 hyperintensity in bifrontal subcortical white matter locations without restricted diffusion, mass effect, susceptibility abnormality, or enhancement. The ventricles and sulci are normal in size. 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 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. Minimal mucosal thickening can be found within the maxillary sinuses. The remaining paranasal sinuses and mastoid air cells are clear. There is no abnormal enhancement within the brain.
There are a few punctate foci of T2 hyperintensity in bifrontal subcortical white matter locations without restricted diffusion, mass effect, susceptibility abnormality, or enhancement. These are nonspecific in appearance, and the differential diagnosis would most likely include minimal small vessel disease, migraine sequelae, or residua from previous head trauma. Given lesional appearance and locations, demyelination is felt to be unlikely.