There are numerous punctate T2/FLAIR hyperintensity in the subcortical white matter of the bifrontal parietal lobes, nonspecific in a patient of this age, may reflect mild early onset chronic microvascular ischemic changes in the appropriate clinical context. There is a small chronic appearing lacunar infarct in the No acute infarct. There is no evidence of hemorrhage or mass lesion. There is no midline shift or herniation pattern. No mass effect is found in the brain. The ventricles, sulci and basal cisterns appear unremarkable. The vertebral and internal carotid arteries demonstrate expected flow voids indicating their patency. The Paranasal sinuses are clear. Impression: No acute abnormalities. Numerous punctuate T2/FLAIR hyperintensity in the subcortical white matter of the bifrontal parietal lobes, nonspecific in a patient of this age, may reflect mild early onset chronic microvascular ischemic changes in the appropriate clinical context.