Dear friend, welcome and thanks for entrusting your query here at Healthcaremagic! I am Dr. Prasad Akole (Critical Care Expert- http://bit.ly/Dr-Prasad-Akole) and am glad to address to your query here. Your MRI is suggestive of long term (chronic) small vessel disease causing limitation of blood supply to small areas in the white matter of the brain (deep small vessel disease). It is common to have it at an advancing age. There is sinusitis (inflammation of sinuses) of the mastoid and other sinuses around the nose. Fluid level in the mastoid sinus behind the ear indicates active infection/ inflammation. This sinusitis is giving rise to your headaches. Do you have fever, imbalance, giddiness? Please be guided by an ENT surgeon for proper treatment of sinusitis. You may need antibiotics and occasionally surgery/ endoscopy. The brain ischaemia needs evaluation and probable aspirin , statin combination if advised by your neurologist. If you are elderly, it is common and not much worrisome. I hope to have answered your query satisfactorily. I would be glad to answer any further queries. Please ask for any clarifications before closing and rating this query. Take care and please keep me informed of your progress at http://bit.ly/Dr-Prasad-Akole Good Luck! Thank you!!