Very extensive predominately peripherally located punctate susceptibility-weighted signal loss regions are demonstrated, with a particularly dense cluster in the left parietal lobe which is associated with increased T2 signal involving both the subcortical white matter and the cortex. These features are consistent with inflammatory cerebral amyloid angiopathy.
Superimposed upon these changes is extensive chronic small vessel ischaemic change with modest fairly generalised volume loss, more pronounced in the frontal lobes. Chronic small vessel ischaemic change is also seen involving the pons. The hippocampi appear small bilaterally, although this is not borne out on morphometry.
Conclusion: inflammatory cerebral amyloid angiopathy.