 There are scattered punctate foci of T2 hyperintensity within the periventricular and subcortical white matter, and to a lesser extent within the pons, without associated mass effect, restricted diffusion, susceptibility and dramatic, or enhancement. The ventricles and sulci are normal in size. The cerebellar tonsils are in normal position. There are no masses, mass effect or midline shift. The pituitary gland is normal in size. There is no evidence for intracranial hemorrhage or acute cerebral, brainstem or cerebellar infarction. No diffusion-weighted abnormalities are identified. 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. There is a suggestion of a 5 mm saccular aneurysm arising from the post-ophthalmic left cavernous internal carotid artery directed laterally.
1.There are scattered punctate foci of T2 hyperintensity within the periventricular and subcortical white matter, and to a lesser extent within the pons, as described in detail above. Given patient age 57 years, as well as a history of hypertension, hyperlipidemia, and diabetes, this most likely represents chronic small vessel ischemic change.2.There is a suggestion of a 5 mm saccular aneurysm arising from the post-ophthalmic left cavernous internal carotid artery directed laterally. Please note conventional MRI is insensitive for the detection and characterization of aneurysms; if deemed clinically beneficial, MRA of the circle of Willis could better define the presence of aneurysms as well as their characterization.