Dysarthria. There is no evidence of acute infarction. There are extensive areas of cerebral and pontine white matter T2 hyperintensity. There are scattered supratentorial and infratentorial punctate foci of susceptibility effect primarily in the deep grey matter structures sand periventricular white matter. There are numerous prominent perivascular spaces in the bilateral basal ganglia, resulting in an etat crible appearance. The ventricles and basal cisterns are prominent and there is ex vacuo dilatation of the left lateral ventricle. There is no midline shift or herniation. The skull and paranasal sinuses are grossly unremarkable. There are intracranial atherosclerotic vascular calcifications. There are bilateral lens implants.
1. No evidence of acute intracranial hemorrhage or acute infarction. 2. Extensive areas of cerebral and pontine white matter signal abnormality likely represent chronic small vessel ischemia. 3. Scattered chronic microhemorrhages, which may be hypertensive in nature.4. Diffuse cerebral volume loss. 