 BRAIN: There are multiple patchy foci of T2 hyperintensity within the supratentorial subcortical white matter bilaterally. There is involvement of the right greater than left anterior temporal lobe, with smaller foci more posteriorly in the left temporal lobe. There is no evidence of intracranial hemorrhage, mass, or acute infarct. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The skull and scalp soft tissues are unremarkable. There is a right maxillary sinus retention cyst.CERVICAL SPINE: The vertebral column alignment is within normal limits. The vertebral body and disc space heights are preserved. The vertebral bone marrow signal is unremarkable. There is no significant spinal canal stenosis. The imaged spinal cord displays normal signal and morphology. The paravertebral soft tissues are unremarkable.
1.Multiple prominent patchy areas of bilateral signal abnormality within the subcortical white matter are nonspecific with the differential including gliosis, demyelinating disease, infectious/inflammatory etiologies such as encephalitis or vasculitis, CADASIL, or less likely metabolic disease, among other etiologies and follow-up imaging is suggested, possibly with contrast. MR spectroscopy could also be considered.2.Normal cervical spine MRI.