Prior multiple bowel surgeries with a chronic TPN, altered mental status. There are multiple small focal susceptibility artifacts on bihemispheric periventricular white matter. These lesions are not associated with surrounding edema or evidence of T1 or T2 signal intensity abnormality indicating nonacute nature. Therefore the possibilities include small parenchymal calcifications or chronic hemorrhagic foci.On FLAIR imaging, patch or nodular bihemispheric scattered high signal intensity lesions indicating nonspecific small vessel ischemic disease.There is no evidence of acute ischemic or hemorrhagic lesion on this scan.The ventricles, sulci and cisterns are symmetric and unremarkable. There is no mass, mass effect, edema, midline shift, intra or extra-axial fluid collection/hemorrhage, or restricted diffusion/acute ischemia. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The paranasal sinuses and mastoid air cells are clear.
1. No evidence of acute ischemic or hemorrhagic lesion.2. Nonspecific small vessel ischemic disease as described above.3. Multiple scattered susceptibility artifact lesions indicate possibility of parenchymal calcification or chronic hemorrhagic foci, possibility of acute focal hemorrhage is unlikely. 