75-year-old female with recent onset of seizures, possible "cerebral T waves" on EEG. Questionable personality changes. No known falls/head trauma. No prior imaging of brain at this hospital. Evaluate for ischemic injury or mass effect. Many sequences are limited by motion. There is no evidence of intracranial hemorrhage, mass, or acute infarct. There are areas of encephalomalacia in the bilateral thalami and basal ganglia, as well as the left pons. There are punctate areas of susceptibility abnormality in the left thalamus as well as the bilateral basal ganglia, which may indicate prior hypertensive encephalopathy. There is moderate periventricular and subcortical T2 hyperintensity, which is nonspecific, but likely represents chronic small vessel ischemic disease. There is diffuse cerebral volume loss. There is no midline shift or herniation. The major cerebral flow voids are intact. There is fluid in the mastoid air cells bilaterally, as well as mucosal thickening involving the right maxillary sinus. The skull and scalp soft tissues are grossly unremarkable. There are bilateral lens implants.
1. Chronic lacunar infarcts in the bilateral deep grey nuclei and pons, as well as scattered microhemorrhages, superimposed upon a background of white matter disease, indicate prior hypertensive encephalopathy, but no evidence of acute infarct.2. Diffuse cerebral volume loss. 3. No evidence of intracranial mass.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.