Female, 42 years old, with rheumatoid arthritis and headaches. Scattered small foci of T2 hyperintensity are again seen within the cerebral white matter, predominantly located in a subcortical distribution. The size and number of the lesions have not significantly changed. No restricted diffusion is seen. No edema or mass effect is detected. There are no findings to suggest acute intracranial hemorrhage or any abnormal extra-axial fluid collections. The ventricles are normal in size and morphology.
Scattered small white matter lesions are unchanged in size and number. The differential remains broad and includes gliosis from prior infection, inflammation or trauma, demyelination, ischemia/vasculitis, as well as sequelae of migraine headache.