Female, 72 years old, status post fall, hit occiput, with headaches, vertigo and altered thinking. Assess for subdural. Numerous scattered foci of T2 hyperintensity are seen within the periventricular and subcortical white matter bilaterally. No restricted diffusion is demonstrated. No parenchymal edema or mass effect is observed. The pattern of intracranial enhancement is within normal limits. No evidence of intracranial hemorrhage or any abnormal extra-axial fluid collection is seen. The left vertebral artery is small, likely a normal anatomic variation. Bone marrow signal characteristics are within normal limits.
1. Numerous scattered small white matter lesions are identified in the cerebral hemispheres. The differential for this is broad and would include chronic microvascular ischemic disease, sequelae of prior demyelination, gliosis, vasculitis or migrainous headache, among others.2. No acute intracranial abnormality and no additional findings which would account for the patient's symptoms.