Clinical question: Evaluate for structural changes or other reasons for cognitive impairment. Signs and symptoms: As above. Nonenhanced brain MRI:Negative diffusion-weighted series.Examination demonstrates extensive patchy and confluent foci of FLAIR hyperintensity in the subcortical and periventricular white matter of bilateral cerebral hemispheres, extensively in bilateral basal ganglia and thalami as well as pons which although nonspecific however considering patient's stated age likely representing advanced age indeterminate small vessel ischemic strokes. This finding demonstrate no associated susceptibility signal changes.There is mild prominence of cortical sulci however with normal size of ventricular system for stated age.No detectable cortical abnormality and the CSF spaces remain unremarkable.Signal void of major intracranial arterial branches are identified and unremarkable.The signal intensity of intracranial venous sinuses remain within normal.Unremarkable images through the orbits and unremarkable calvarium.
1.No acute intracranial process.2.Findings suggestive of extensive chronic nonhemorrhagic small vessel ischemic strokes as detailed.