Patient with worsening mental status, worsening lymphoma evaluate for cns involvement. There are scattered areas of T2/FLAIR hyperintensity in the subcortical and periventricular white matter. No midline shift or mass effect is appreciated. The cortical sulci are in proportion to cerebral ventricles. There is no diffusion restriction to suggest acute or subacute ischemia. No acute intracranial hemorrhage is identified. There is a small amount of fluid present within the right mastoids. Mild scattered paranasal sinus mucosal thickening is seen.
A few scattered foci of T2/FLAIR hyperintensity in the subcortical and periventricular white matter are nonspecific however can be seen with mild to moderate chronic microvascular ischemic disease in a patient of this age.