Altered mental status and stroke. There is no evidence of intracranial hemorrhage, mass, or acute infarct. There is periventricular and subcortical T2/FLAIR hyperintensity in a similar distribution to the prior MRI. The ventricles are prominent in proportion to the sulci compatible with parenchymal volume loss. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.
1. No evidence of acute infarction, acute intracranial hemorrhage, or mass.2. Periventricular and subcortical white matter chronic small vessel ischemic disease is not significantly changed from the prior MRI.