What does this mean?

[jolonzo]

IMPRESSION:
 
1) Greater than expected atrophy is evident, given the the patient's age. Extensive, partially confluent foci of increased signal, on T2 and FLAIR sequences, are present in the periventricular white matter tracts, predominantly corona radiata and centrum semiovale, with primary diagnostic consideration given to precocious chronic microvascular ischemic sequelae. Additional diagnostic considerations are as described in the report body.
2) No enhancing abnormalities of the optic tracts are identified. There are no findings for suprasellar mass. No areas of pathological gadolinium enhancement are identified. There are no findings for acute territorial infarction or intracranial hemorrhage.
 
END OF IMPRESSION:
 
INDICATION: Visual field defect, and visual blurring in the right eye. The patient is a 54-year-old female.
 
TECHNIQUE: Dedicated 1.5 Tesla magnet multiplanar/multisequence MRI examination of the brain was performed.
 
CONTRAST: 9.6 mL of Gadavist was administered intravenously.
 
COMPARISON: None.
 
FINDINGS:
 
The ventricular system, sulci and cisterns demonstrate normal configuration. There is slightly greater than expected supratentorial atrophy, given the patient's age of 54 years. There are no findings for acute territorial infarction or intracranial hemorrhage.
 
There is an old, large lacunar infarct within the central right pontine hemisphere, caudal aspect. The periventricular white matter tracts demonstrate extensive, partially confluent, nonspecific foci of increased signal on T2 and FLAIR sequences, most pronounced within the centrum semiovale and corona radiata, likely representing precocious chronic microvascular ischemic sequelae. Other less likely diagnostic considerations would include infectious processes such as Lyme disease, demyelinating processes such as multiple sclerosis, or sequelae of migraine headaches, collagen vascular disease or vasculitis.
The vestibulocochlear nerve complexes, pituitary gland, and craniovertebral junction are unremarkable in appearance. There are no findings for suprasellar mass. The pituitary infundibulum is midline. No abnormality of the optic chiasm or optic radiations is identified. No areas of pathological gadolinium enhancement are evident. The intracranial flow-voids are unremarkable in appearance, as are the mastoid regions. Areas of bibasilar maxillary sinus mucoperiosteal thickening are present with right-sided air-fluid level, compatible with an acute sinusitis.