Memory impairment, cognitive decline, and paresthesias. There is no evidence of intracranial hemorrhage, mass, or acute infarct. There is scattered cerebral white matter T2 hyperintensity. There is also a subcentimeter defect in the left pons. There is no abnormal intracranial enhancement. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, and scalp soft tissues are grossly unremarkable. There are bilateral parotid gland nodules, which are grossly unchanged from 2009. There is moderate mucosal thickening in the right maxillary sinus. There is mild fluid within the right mastoid air cells.
1. No evidence of acute intracranial hemorrhage, mass, or acute infarct. Mild scattered nonspecific cerebral white matter disease suggestive of chronic small vessel ischemic disease and a chronic lacunar infarct in the pons, but no findings to suggest a particular neurodegenerative condition. 2. There are bilateral parotid gland nodules, which are grossly unchanged from 2009 and likely represent lymph nodes. 