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MRI images demonstrating an extensive area of hyper T2/FLAIR signal abnormalities involving both the anterosuperior aspects of both cerebellar hemispheres, cerebellar vermis, pons, midbrain, both cerebral peduncles and the inferior thalami. It demonstrates high signal on DWI that correlates with diffusion restriction on the ADC map.
The brain has diffuse volume depletion in keeping with the patient's age group, with no lobar predominance. Multiple enlarged perivascular spaces are noted in the basal ganglia bilaterally. Old lacunar infarcts on the left. Moderate chronic small vessel ischaemic changes within the supratentorial white matter.