79 years, Male, gait change, NPH. There are multiple patchy areas and scattered foci of T2/FLAIR hyperintensity in the bilateral subcortical and periventricular white matter, which are nonspecific, but compatible with moderate burden of chronic small vessel ischemic disease. Small foci of T2 hyperintensity in the inferior basal ganglia are likely related to perivascular spaces. Cystic foci such as the left caudate head, right pons, and left frontal corona radiata are suspected to represent chronic lacunar infarcts. No restricted diffusion to suggest acute ischemia. No intracranial hemorrhage. No intracranial mass or mass-effect. There is asymmetric enlargement of the left lateral ventricle which can be a normal variant. Overall however the ventricular system is not enlarged to suggest hydrocephalus. There is a 6 mm x 11 mm focus of T2 hyperintensity involving the right aspect of the sella which is incompletely evaluated.Major flow-voids are preserved. Minimal mucosal thickening is seen involving the paranasal sinuses, which is are otherwise clear. Minimal opacification of the mastoid air cells is also noted. Calvarium and extracranial soft tissues are unremarkable.
1. Overall findings are consistent with moderate degree of chronic small vessel ischemic disease. No findings to suggest hydrocephalus/NPH.2. Incidentally noted is a small T2 hyperintense focus in the right aspect of the sella which is incompletely evaluated without contrast and may represent a Rathke's cleft cyst or cystic adenoma.