Findings:
Mild involutional changes are seen in the brain parenchyma in the form of prominent cortical sulci and widened ventricles.
No intra- or extra-axial mass lesion or collection is identified. There is no midline shift.
Multiple FLAIR hyperintense lesions in the supratentorial white matter, confluent in the periventricular regions, are in keeping with moderate small vessel ischemia.
Multiple small perivascular spaces seen throughout the basal ganglia, in keeping with status cribrosum (État criblé).
T2 and FLAIR hyperintensity in the pons extending to both sides of midline and sparing of periphery suggesting demyelination.
No abnormal signal on the susceptibility-weighted images or diffusion/ADC images is identified.
The pituitary gland is normal.
Mucosal thickening is seen in the left ethmoid and maxillary sinuses. The paranasal sinuses and the mastoid air cells are otherwise clear. Bilateral IOL-implants are noted.
No bony abnormality is seen. The craniocervical junction is normal.
Conclusion:
Features suggestive of central pontine myelinolysis (osmotic demyelination syndrome).
No recent ischaemic event.
Moderate small vessel ischaemic disease.