 There is no evidence of acute infarct. The ventricles and sulci are prominent, consistent with mild age-related volume loss. In addition, the ventricular prominence appears somewhat disproportionate to sulcal prominence. There is no midline shift or mass effect. There are scattered punctate foci and confluent areas of abnormal T2/FLAIR hyperintensity within the basal ganglia as well as the periventricular and subcortical white matter, consistent with moderate chronic small vessel ischemic changes. Chronic lacunar infarcts are present within the right head of the caudate. Scattered punctate foci of susceptibility are present most prominent in the bilateral basal ganglia. There is no abnormal intracranial enhancement. The midline structures and craniocervical junction are within normal limits. The major cerebral flow voids are intact. There is minimal mucosal thickening in the right frontoethmoidal recess. The remainder of the visualized portions of the paranasal sinuses and mastoids/middle ears are grossly clear.
1.No evidence of acute ischemic infarction. Moderate chronic small vessel ischemic changes.2.No evidence of mass lesion to account for patient's seizures.3.Scattered presumed chronic microhemorrhages most prominent in the basal ganglia which may be related to hypertension, with peripheral findings also possibly related to amyloid angiopathy.4.Disproportionate ventricular dilatation with respect to sulci. While this simply may be related to preferential periventricular white matter volume loss from chronic small vessel ischemic changes, correlate for symptoms of normal pressure hydrocephalus.