Female, 66 years old, with, and parkinsonism, question of central tremor versus Parkinson's disease or both. Moderately extensive patchy foci of white matter T2 hyperintensity are seen in the bilateral cerebral hemispheres and the pons. No evidence of restricted diffusion is seen. No parenchymal edema or significant generalized mass effect is detected. No abnormal extra-axial collections are seen. There are no findings to suggest acute intracranial hemorrhage. The ventricular system is normal in size and morphology. Overall brain parenchymal volume is within normal limits.
Moderately extensive patchy white matter lesions are seen, predominantly in the cerebral hemispheres. The differential for this finding is broad and would include chronic microvascular ischemic disease, sequelae of demyelination, as well as sequelae of other inflammatory processes and/or vasculitis. No other specific findings are seen to account for the patient's symptoms.