Cognitive impairment and memory decline. There is no evidence of intracranial hemorrhage, mass, or acute infarct. There is global parenchymal volume loss. There is no midline shift or herniation. There are symmetric bilateral T2 hyperintensities involving predominantly the inferior basal ganglia without edema or mass effect. There are 1-2 small foci of nonspecific T2 hyperintensity in the right parietal lobe. There are no other areas of significant abnormality.The major cerebral flow voids are intact. There is mild mucosal thickening involving the maxillary and ethmoid sinuses. There is nonspecific left parietal bone lesion, likely benign.
No definite findings to account for patient's symptoms. Bilateral chronic appearing signal abnormality in the lower basal ganglia is seen which may be incidental. Given the clinical presentation, the differential would include sequelae of prior toxic exposure, metabolic derangement or infection.