Vascular dementia, with questionable new right pronator drift from last visit. Please assess for new interval stroke. There are scattered areas of cerebral and pontine T2 hyperintensity. There are unchanged punctate foci of susceptibility effect in the bilateral frontal lobe, which may represent chronic microhemorrhages. However, there is no evidence of acute intracranial hemorrhage, mass, or acute infarct. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable. There are bilateral lens implants.
Chronic scattered white matter small vessel ischemic disease, but no evidence of acute intracranial hemorrhage, mass, or acute infarct.