42-year-old female with face tingling and recent fatigue, prior abnormal brain MRI No diffusion restriction is seen to suggest acute ischemia. No susceptibility weighted artifact is seen to suggest intracranial hemorrhage. Scattered T2/FLAIR hyperintense foci are seen in the periventricular and subcortical white matter, without significant interval change. One appears slightly more prominent within subcortical white matter of the right posterior superior frontal gyrus (series 401 image 25), whereas a second lesion appears less prominent involving left frontal subcortical white matter (series 401 image 22). No lesions are seen within the posterior fossa. No new lesions are identified. The CSF spaces are appropriate for the patient's stated age with no midline shift. Prominent perivascular spaces are again seen in the right inferior basal ganglia. Normal vascular flow voids are present in the major intracranial vasculature. The imaged portions of the paranasal sinuses are clear. The imaged portions of the mastoid air cells are clear. The imaged portions of the orbits are intact.
Redemonstrated are scattered T2/FLAIR hyperintense in the periventricular and subcortical white matter, without significant interval change. One appears slightly more prominent within subcortical white matter of the right posterior superior frontal gyrus (series 401 image 25), whereas a second lesion appears less prominent involving left frontal subcortical white matter (series 401 image 22). No new lesions are identified. This appearance is nonspecific and the differential diagnosis most likely includes demyelinating disease, migraine sequela, diffuse axonal injury, and small vessel ischemic disease. 