84 years, Female, severe dizziness. No restricted diffusion to suggest acute ischemia. No intracranial mass or mass-effect. High-resolution images of the temporal bones specifically demonstrate no mass involving the cerebellopontine angles or internal auditory canals. The ventricles are within normal limits in size and configuration. Several foci of T2/FLAIR hyperintensity are seen in the bilateral subcortical and periventricular white matter, which are nonspecific, but compatible with mild chronic small vessel ischemic changes. Punctate foci of susceptibility effect are seen in the right occipital lobe and in the right cerebellar hemisphere which are compatible with chronic microhemorrhages. Brain parenchyma is otherwise unremarkable for age. No abnormal parenchymal or meningeal enhancement. Major flow-voids are preserved. Bone marrow signal and remainder of the extracranial soft tissues are within normal limits.
1. No evidence of acute infarct, intracranial mass, or abnormal enhancement to explain patient's symptoms.2. Mild chronic small vessel ischemic changes. 