Prominent perivascular spaces
Presented with long standing headache.
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A T2 hyperintense/ T1 hypointense cystic, non enhancing clustered multiple foci in the white matter of the right parietal, occipital and temporal lobes consistent with enlarged perivascular spaces. No associated mass effect. No midline shift or downward herniation. No restricted diffusion.
Small burden of FLAIR periventricular and white matter hyperintensities most likely secondary to early microvascular disease.
Normal intracranial flow voids.
Excellent example of prominent perivascular spaces type II.