Moderately extensive foci of increased FLAIR and T2 signal evident within the periventricular white matter and subcortical white matter in the frontal and parietal lobes and sub insular white matter unchanged in comparison to the previous scan from two years prior. Small foci are evident within the basal ganglia and the largest confluent area is laterally on the right frontal lobe. Further FLAIR hyperintensity is evident in the subcortical white matter of the anterior temporal lobes, a more specific feature of CADASIL. There is no evidence of restricted diffusion. No critical intracranial vascular stenosis.
Impression: Stable appearances and features suspicious for CADASIL.