 There is no acute infarct, mass effect, or cerebral edema. There is a chronic right pontine microhemorrhage which is new from prior MRI from April 2013. There is a chronic right cerebellar microhemorrhage which is unchanged from April 2013. There is moderate global sulcal prominence again seen. There is moderate periventricular and subcortical white matter T2 signal abnormalities which are nonspecific, likely representing chronic microvascular ischemic changes (including central pons). The optic nerves are inadequately evaluated on this exam although no gross abnormalities are identified on the axial images. There is no midline shift or herniation. The skull and extracranial soft tissues are unremarkable.
1.No acute infarct or mass effect. 2.Moderate global volume loss (advanced for patient age) and moderate chronic small vessel ischemic disease. Please note optic nerves are not adequately assessed on current study and MRI orbit can be considered as clinically indicated.3.Focus of susceptibility likely representing chronic microhemorrhage involving the right pons is new since April 2013.4.Chronic left pontine infarct again seen.