 There is no evidence for intracranial hemorrhage or diffusion-weighted abnormalities. There are multiple foci of T2/FLAIR hyperintensity in the bilateral subcortical and periventricular white matter which is nonspecific but compatible with chronic small vessel ischemic disease. There is more focal signal abnormality involving the left insular cortex, subinsular white matter, and left frontal operculum compatible with chronic ischemia. There are no masses, mass effect or midline shift. The ventricles and sulci are normal in size. There are no intraaxial or extraaxial fluid collections. Flow voids are present within the major vessels indicating patency. There is right maxillary mucous retention cyst and left maxillary sinus mucosal thickening. Scattered opacification of ethmoid air cells. Mastoid air cells are clear. Orbits are unremarkable.
1.No acute infarct.2.Moderate chronic small vessel ischemic changes. More focal signal abnormality involving the left insular cortex, subinsular white matter, and left frontal operculum also compatible with chronic ischemia. 