There is diffuse extensive periventricular deep white matter T2 hyperintensity changes, with associated ex vacuo ventriculomegaly and global, symmetrical, supra and infratentorial involutional changes.
Multiple punctate focus of susceptibility signal loss within the cerebellar hemispheres, pons, thalami and basal ganglia. No regions of restricted diffusion.
No intra or extra-axial collections.
Extensive diffuse periventricular white matter change can be attributed to background small vessel ischaemic disease, the extent of the changes are disproportionate to the patient's age. Numerous microhaemorrhages are in a distribution suggestive of chronic hypertensive encephalopathy (hypertensive microangiopathy) .