New confusion, dementia. There is no evidence of intracranial hemorrhage, mass, or acute infarct. There is scattered subcortical, deep, and periventricular cerebral white matter T2 hyperintensity. There is also patchy T2 hyperintensity in the pons. There is no abnormal intracranial enhancement. There is mild diffuse cerebral volume loss. There is no midline shift or herniation. There may be a small right supraclinoid internal carotid artery outpouching. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.
1. The white matter lesions are nonspecific, but may represent chronic small vessel ischemic disease. Otherwise, no evidence of intracranial hemorrhage, mass, or acute infarct. 2. Possible small right supraclinoid internal carotid artery outpouching, which may represent an aneurysm versus volume averaging. Dedicated angiographic imaging may be useful.