46-year-old male with recurrent headaches The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal enhancing mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.There is a punctate left frontal periventricular white matter lesion present a similar but smaller lesion is present in the subcortical white matter of the left insular cortex. These are bright on FLAIR and T2 MRI. There is no associated diffusion restriction or contrast enhancement.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses demonstrate minor scattered opacities. The visualized portions of the mastoid air cells demonstrate minor opacities in the right mastoid air cells. The visualized portions of the orbits are intact.
1.Minor subcortical white matter lesions in isolation are nonspecific and likely of little clinical significance.