Aphasia. Rule out acute stroke. While there is no acute infarct, the cerebral white-matter shows relatively mild T2/FLAIR hyperintensity in scattered deep/subcortical and confluent periventricular distribution. This is nonspecific but likely reflective of chronic microvascular ischemia. In addition, susceptibility-weighted imaging shows numerous tiny foci of hemosiderin staining predominantly in a subcortical distribution in both cerebral and both cerebellar hemispheres with less extensive central involvement of the deep gray nuclei. The largest of these involve the right precentral gyrus and measures 3 mm. None is associated with surrounding edema. There is moderate expansion of the ventricles, sulci and other CSF-containing spaces reflective of moderate underlying brain volume loss. There is no midline shift or herniation. The major cerebral flow voids are intact. The skull and scalp soft tissues are grossly unremarkable. There has been bilateral eye lens replacement. There is mild ethmoid mucosal thickening and small maxillary retention cyst.
1.No evidence of acute intracranial hemorrhage, mass, or acute infarct.2.Numerous foci of susceptibility effect throughout the brain reflect microbleeds, predominantly in a peripheral distribution, which might be reflective of amyloid angiopathy. No sizable intracranial hemorrhage. 3.There are also changes of chronic microvascular ischemia in the cerebral white-matter in addition to moderate global parenchymal volume loss.