Female, 86 years old, with persistent dizziness. Fairly extensive patchy periventricular and brainstem T2 hyperintensity is seen. In addition, there are numerous chronic lacunar infarcts of the basal ganglia and thalami. A focus of encephalomalacia within the pons is also likely related to prior ischemia.No restricted diffusion is seen to suggest acute ischemia. No evidence of parenchymal edema or mass effect is detected. There are a few scattered punctate foci of susceptibility in the brain parenchyma likely representing chronic microhemorrhage, but no areas of acute intracranial hemorrhage are suspected. The ventricles are normal in size and morphology. There may be cystic degeneration of the pineal gland.A nonspecific soft tissue nodule is evident within the left parotid space.A fluid level is present in the right maxillary sinus and the mastoid air cells show mild opacification.
1.Sequelae of extensive prior microvascular ischemic disease.2.No evidence of any definite acute intracranial abnormality.3.A nonspecific nodule is partially visualized in the left parotid space. This could be further assessed with ultrasound if clinically warranted.