71 year old female with frequent falls, instability. Evaluate for prior stroke, demyelinating disease. There is no restricted diffusion on DWI sequences to suggest acute ischemic infarction. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. There is a moderate patchy periventricular and subcortical white matter T2 and FLAIR hyperintense foci similar to prior study consistent with chronic small vessel ischemic disease. There is mild prominence of the ventricles and sulci consistent with mild age-related volume loss. The post contrast images are motion degraded. No large enhancing intracranial lesions are identified. Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
1. No evidence of acute ischemic infarction or intracranial hemorrhage. 2. Chronic small vessel ischemic disease. 