Brief Answer:
Patient need proper evaluation for ischemic findings in brain.

Detailed Answer:
Hello

Chronic white matter ischemic changes in bilateral fronto-parietal subcortical white matter may be due to ischemia( decreased blood supply and oxygenation due to involvement of small blood vessels).

Ischemic changes generally occurs in conditions like hypertension,altered lipid profile,diabetes mellitus,vasculitis etc.These conditions damage small blood vessels and this leads to ischemia.
So,Patient need screening of these conditions.It includes proper clinical examination and investigations like routine hemogram,random blood sugar,liver function test,renal function test,lipid profile,urine RE/ME.

Patient may need to take few medicines after evaluation.

However other causes may be demyelinating disease,migraine headache,edema etc.These conditions should also be ruled out and patient may need follow up MRI to see progression of lesions.

MRI findings also indicate mild degenerative changes in cervical spine.
Degenerative changes are age related findings.It is due to chronic stress on annulus fibrosis.

At C3-4,C4-5 and C5-6 level,there is small focal herniation of inter vertebral disc in postero-central direction which is indenting over thecal sac.
It is important to know about nerve root compression etc.

Majority of degenerative disc disease patients are benefited by conservative treatment in the form of physiotherapy,analgesics and muscle relaxants.
Surgery should be the last option.

Since patient have mild findings,I expect patient will need only conservative treatment.
Treatment can be planned after consultation with neurologist.

Get well soon.
Hope I have answered your question.
Further queries are most welcome.
Please rate my answer if you are satisfied.

Take Care
Dr.Indu XXXXXXX

---