<s>[INST] I am 66 years old, and have bipolar 1 disorder. I just got the results of an MRI: HISTORY: Dementia; Cognitive impairment without underlying source identifies.. Symptoms for 5 years COMPARISON: None. TECHNIQUE: 16 mL MultiHance was injected IV. Precontrast and postcontrast multiplanar MR images were obtained of the brain. FINDINGS: Brain and dura: There are a few scattered nonspecific punctate foci of increased white matter signal. Brain volume loss is present. No bleed, edema, or mass/mass effect. Ventricles and sulci: Normal. Vessels: Vascular flow voids are preserved. Calvarium: Marrow signal is normal. Craniocervical junction is intact. Orbits, sinuses, and facial soft tissues: Normal. IMPRESSION: Mild diffuse brain volume loss and mild chronic small vessel ischemic changes. I also had 7-1/2 hours of testing with a neuropsychologist. I m waiting for an appointment with a neurologist. I m starting to be scared. [/INST] Hi, The report means that there are very small blood clots in the brain. Due to this the brain size is slightly reduced. This is not very uncommon with increasing age.  If you have diabetes or hypertension you should control to avoid a further stroke. Also, you may be advised to take a baby Disdain if not contraindicated.  There are no major abnormalities like any a tumor or infection in your brain. Hope I have answered your query. Let me know if I can assist you further. </s>