Syncopal event versus seizure at home. Evaluate for structural abnormality. There is no evidence of intracranial hemorrhage, mass, or acute infarct. There is parenchymal volume loss including the bilateral hippocampi. The ventricles and basal cisterns are normal in size and configuration for age. There is no midline shift or herniation. There are scattered punctate foci and confluent areas of abnormal T2/FLAIR hyperintensity within the periventricular and subcortical white matter and pons, consistent with moderate chronic small vessel ischemic changes. There are scattered foci of susceptibility artifact particularly at the right thalamus, likely representing chronic hemosiderin deposition. The skull and extracranial soft tissues are unremarkable. There is soft tissue thickening around the odontoid process which can be seen with entities such as CPPD. There are bilateral lens implants.
1.No intracranial mass or mass effect. No evidence of acute infarct.2.Scattered foci of T2 hyperintense signal in the periventricular subcortical white matter, which are nonspecific, but likely represent moderate chronic small vessel ischemic changes.3.Multiple foci of chronic microhemorrhage particularly involving the right thalamus which can be seen with chronic hypertension.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.