Female, 65 years old, with severe right-sided headache and neck pain. Patchy periventricular T2 hyperintensity is seen along with numerous scattered subcortical foci of T2 signal abnormality. Prominent patchy T2 hyperintensity is also noted within the pons.No evidence of restricted diffusion is seen. No parenchymal edema or mass effect is detected. On postcontrast images, no pathologic parenchymal or extra-axial enhancement is detected.There is no evidence of intracranial hemorrhage or any abnormal extra-axial fluid collection. The ventricles are normal in size and morphology.
1. No acute intracranial abnormality and no specific findings are seen which would clearly account for the patient's symptoms.2. Note is made of fairly extensive white matter signal abnormality which is nonspecific. These findings most commonly represent chronic microvascular ischemic disease, although other etiologies including demyelination, vasculitis, and sequela of prior inflammation may also be considered.