 There are few punctate foci of mildly high signal on DWI with corresponding low signal on ADC in the right parahippocampal gyrus (series 501 image 223), left posterior frontal/parietal lobe cortex (series 501 image 227) and right medial parietal/occipital lobe cortex (series 501 image 231). A punctate focus of apparent high DWI signal in the left periventricular white matter on series 501 image 228 is likely T2 shine through artifact. There is mild/moderate nonspecific confluent T2 hyperintensity in the periventricular and subcortical white matter, likely representing chronic microvascular ischemic changes. There is left medial and inferior cerebellar hemispheric encephalomalacia. There is mild age-related sulcal prominence. There is no hydrocephalus. There is scattered bilateral mastoid air cell high T2 signal.
1.Few punctate foci of small vessel distribution acute to subacute infarcts in the left posterior frontal/parietal cortex, right medial temporal lobe and parietal/occipital lobes. 2.Moderately advanced chronic small vessel ischemic changes.