Clinical question: Rule out multiple infarcts. Signs and symptoms: Memory loss, left carotid stenosis. Nonenhanced brain MRI:Negative diffusion weighted series.Images through posterior fossa are unremarkable and in particular without evidence of stroke and stable since prior study.Images through the supratentorial space demonstrate scattered small foci of FLAIR hyperintensity in the periventricular white matter of bilateral cerebral hemispheres and to a lesser degree in bilateral subcortical white matter with no convincing evidence of any significant change since prior exam from 2011. Although nonspecific this appearance often represent microvascular ischemic changes of mild degree in this patient.There is mild prominence of supratentorial ventricular system with slight interval progression since prior exam from 2011.Cortical sulci and ventricular system as well as CSF spaces remain within normal for age.The signal void of major intracranial arterial branches are identified.Unremarkable calvarium, soft tissues of the scalp, paranasal sinuses, mastoid air cells/middle ear cavities and orbits.
1.No acute intracranial process.2.Findings suggestive of mild chronic nonhemorrhagic small vessel ischemic strokes without convincing evidence of interval progression since prior exam from 2011.3.Supratentorial ventriculomegaly with slight interval progression since prior study from 2011.