 MRI brain The ventricles and sulci are within normal limits. 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, unchanged from prior. There is stable chronic lacunar infarct in the left external capsule. The basal cisterns remain patent. There is no midline shift or mass effect. 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 scattered opacification of the paranasal sinuses, minimally improved.MR thoracic spine: The thoracic spine is in normal alignment, with slightly exaggerated normal thoracic kyphosis. The vertebral heights are well-maintained. There is developmental ventral narrowing of the intervertebral disc between T4-T5 and fusion of the vertebrae posteriorly. There is mild disc desiccation and narrowing scattered along the mid to lower thoracic spine. There is mildly diffuse heterogeneous marrow signal which is nonspecific, with minimal endplate degenerative changes in the thoracic spine. There is a rounded T1 and T2 hypointense lesion in the T9 vertebral body, which likely represents an atypical hemangioma. No worrisome focal marrow signal abnormality is appreciated. The spinal cord is of normal caliber and signal.There is a subcentimeter perineural cyst at right T8 level. There is mild thickening of the ligamentum flavum and facet arthropathy at the T12-L1 level. There is no significant disk bulge, herniation, spinal canal or foraminal stenosis within the thoracic spine.
1. No evidence of acute intracranial ischemia, edema or mass effect.2. Moderate chronic small vessel ischemic disease and chronic lacunar infarct in the left external capsule, unchanged.3. Mild degenerative changes in the thoracic spine, otherwise unremarkable MRI. There is developmental partial fusion of T4-T5.