 The ventricles and sulci are prominent, consistent with mild age-related volume loss, commensurate with age. The basal cisterns remain patent. There is no midline shift or mass effect. There are scattered punctate foci and confluent areas of abnormal T2/FLAIR hyperintensity within the periventricular and subcortical white matter, consistent with moderate chronic small vessel ischemic changes. There is no diffusion abnormality. No extra-axial fluid collection is identified. Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits. There is mild, right greater than left, opacification of the mastoid air cells.
No evidence of acute infarct. Moderate chronic small vessel ischemic changes.