78 years, Male, vertigo, rule out brainstem lesion. History of hypertension. No restricted diffusion to suggest acute ischemia. No intracranial mass or mass-effect. The ventricles are within normal limits in size and configuration for age. Several foci of T2/FLAIR hyperintensity are seen in the bilateral subcortical and periventricular white matter, which are nonspecific, but compatible with mild chronic small vessel ischemic changes. There is a punctate focus of susceptibility in the left temporal subcortical white matter which is compatible with a chronic focus of microhemorrhage. Foci of susceptibility are also evident within the pons and also compatible with chronic microhemorrhages. Brain parenchyma is otherwise unremarkable for age. Major flow-voids are preserved.Sella and orbits are grossly within normal limits. Paranasal sinuses and mastoid cells are clear. Bone marrow signal and extracranial soft tissues are within normal limits.
1. Mild chronic small vessel ischemic changes as well as few small foci of chronic microhemorrhage including within the pons, which may be related to chronic hypertension.2. Brain parenchyma is otherwise unremarkable for age.