 There are scattered foci of T2 hyperintensity within the periventricular and subcortical white matter without associated mass effect, restricted diffusion, susceptibility abnormality, or enhancement. Prominent perivascular spaces are commonly seen in a patient of 82 years. There is mild diffuse volume loss without a specific lobar predominant atrophy pattern. There are no findings of hydrocephalus.. The cerebellar tonsils are in normal position. There are no masses, mass effect or midline shift. The pituitary gland is normal in size. There is no evidence for intracranial hemorrhage or acute cerebral, brainstem or cerebellar infarction. No diffusion-weighted abnormalities are identified. There are no extraaxial fluid collections or subdural hematomas. Flow voids are present within the major vessels indicating patency. Mucosal thickening is present within the left frontal, anterior left ethmoid, and left maxillary sinuses. A superimposed small air-fluid level is present in the left maxillary sinus. The remaining paranasal sinuses and the mastoid air cells are clear. There is no abnormal enhancement within the brain. Note is made of endosteal hyperostosis.Coronal images of the temporal lobes demonstrate the hippocampal formations and parahippocampal gyri to be unremarkable bilaterally without signal abnormalities, masses, or abnormal enhancement. There are no foci of heterotopic gray matter.
1.Chronic small vessel ischemic disease.2.Mild diffuse volume loss without a specific lobar predominant atrophy pattern.3.Mucosal thickening is present within the left frontal, anterior left ethmoid, and left maxillary sinuses. A superimposed small air-fluid level is present in the left maxillary sinus. 