61 years, Female, new onset headaches No intracranial mass or mass effect. No intracranial hemorrhage. There are multiple foci of T2/FLAIR hyperintensity are seen in the bilateral subcortical and periventricular white matter, which are nonspecific, but compatible with mild to moderate chronic small vessel ischemic changes. No diffusion abnormality to suggest recent ischemia. There is global parenchymal volume loss which appears advanced for patient's age. No hydrocephalus. No extra-axial collections. Major flow-voids are preserved.Sella and orbits are grossly within normal limits. There is minimal mucosal thickening involving the paranasal sinuses which are otherwise clear. There is moderate opacification of the right mastoid air cells. Bone marrow signal and extracranial soft tissues are within normal limits.
1. No evidence of intracranial mass or mass effect.2. Mild to moderate chronic small vessel ischemic disease.3. Global parenchymal volume loss which appears mildly prominent for age.