 Several sequences are motion degraded. Given this caveat:There is a small, focal area of restricted diffusion with matching ADC hypointensity based at the posterior limb of the left internal capsule without enhancement. There are non restricting foci of T2 hyperintensity within the periventricular and subcortical white matter, confluent in several locations, with similar findings to a lesser degree within the pons. These are not associated with mass effect, enhancement, or susceptibility abnormality. A tiny focus of encephalomalacia within the right inferior cerebellar hemisphere is consistent with a remote age small vessel infarct. There is mild diffuse volume loss without a specific lobar predominant atrophy pattern. The cerebellar tonsils are in normal position. There are no masses, mass effect or midline shift. Redemonstrated is a partial empty sella. There is no evidence for intracranial hemorrhage. There are no extraaxial fluid collections or subdural hematomas. Flow voids are present within the major vessels indicating patency. The paranasal sinuses and mastoid air cells are clear. There is no abnormal enhancement within the brain. Incidental note is is made of a 4.3 cm transverse dimension benign lipoma overlying the right paramedian suboccipital scalp.
1.There is a small, focal area of acute infarction based at the posterior limb of the left internal capsule.2.Advanced chronic small vessel ischemic disease.3.Mild diffuse volume loss without a specific lobar predominant atrophy pattern.