Visual loss; unable to read but able to see far away. There appears to be a punctate focus of restricted diffusion in the medulla centrally without discernible T2 hyperintensity. There are subcentimeter foci of T2 hyperintensity in the right pons and bilateral basal ganglia. There is also mild diffuse periventricular white matter T2 hyperintensity. There is mild diffuse cerebral volume loss. There is no midline shift or herniation. The major cerebral flow voids are intact. The skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable. There are bilateral lens implants.
1. Apparent punctate focus of restricted diffusion in the medulla centrally may represent an acute infarct versus artifact.2. Probable chronic lacunar infarcts in the right pons and bilateral basal ganglia. 3. Mild diffuse cerebral volume loss.