Cognitive decline with prior strokes and Parkinson disease: please assess for burden of cerebrovascular disease. There are small areas of encephalomalacia in the bilateral deep grey matter structures and anterior right frontal lobe superimposed upon a background of diffuse bilateral cerebral hemisphere white matter T2 hyperintensity, primarily in a periventricular distribution. There is no evidence of intracranial hemorrhage or acute infarct. There is mild diffuse cerebral volume loss. There is an unchanged subcentimeter extra-axial lesion with susceptibility effect along the anterior right frontal convexity. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and mastoid air cells are grossly unremarkable. There is a subcentimeter nodule in the left occipital scalp, which may represent an inclusion cyst, but has gradually increased in size.
1. Small chronic infarcts in the bilateral deep grey matter structures and anterior right frontal lobe superimposed upon a background of chronic small vessel ischemic disease, but no evidence of acute acute infarct.2. An unchanged subcentimeter extra-axial lesion with susceptibility effect along the anterior right frontal convexity may represent a calcified meningioma.3. A subcentimeter nodule in the left occipital scalp, which may represent an inclusion cyst, but has gradually increased in size and is incompletely characterized. 