Clinical question, indeterminate age stroke. Signs and symptoms: Unsteady gait. Pre and post enhanced brain MRI:Negative diffusion weighted images.Examination demonstrate extensive periventricular and to a lesser degree subcortical patchy and confluent foci of FLAIR/T2 hyperintensity consistent with mild to moderate age-indeterminate small vessel ischemic strokes.Very minimal similar findings are noted in the bilateral basal ganglia and thalami and pons and with small foci of bilateral chronic cerebellar ischemic stroke. There is no associated susceptibility signal changes with the findings.Slight prominence of ventricular system and the cortical sulci likely representing ex vacuo dilatation is noted. Midline is maintained.There is no detectable abnormal enhancement of brain parenchyma or the meninges.Unremarkable calvarium and orbits without evidence of abnormal enhancement.All paranasal sinuses and bilateral mastoid air cells and middle ear cavities demonstrate normal pneumatization signal.
1.No acute intracranial process.2.Findings suggestive of moderate chronic nonhemorrhagic small vessel ischemic strokes and small bilateral cerebellar chronic ischemic strokes.3.No detectable abnormal parenchymal, leptomeningeal, calvarial or orbital enhancement.