Memory deficits, multiple infarcts?. There is encephalomalacia involving the right parietal and right temporal lobes consistent with prior infarcts. These infarcts primarily involve the right inferior parietal lobule, the right superior temporal gyrus, and the adjacent white matter. The bilateral hippocampi demonstrate mild volume loss similar to remainder of the brain. No restricted diffusion to suggest acute ischemia. There is a small pineal cyst measuring 9 x 9 mm. No suspicious intracranial mass or mass-effect. No hydrocephalus. Several foci of T2/FLAIR hyperintensity are seen in the bilateral subcortical and periventricular white matter, which are nonspecific, but compatible with mild chronic small vessel ischemic changes. There are multiple punctate foci of susceptibility effect involving the bilateral cerebral hemispheres as well as the bilateral cerebellar hemispheres. Major flow-voids are preserved.Sella and orbits are grossly within normal limits. Small left maxillary mucous retention cyst. Paranasal sinuses and mastoid cells are clear. Bone marrow signal and extracranial soft tissues are within normal limits.
1. Chronic infarcts involving the right parietal and right temporal lobes.2. Mild chronic small vessel ischemic changes.3. Multiple punctate foci of chronic microhemorrhages involving the bilateral cerebral and cerebellar hemispheres in a nonspecific distribution and may be related to amyloid angiopathy and/or hypertension. 