Hello
There are chronic white matter changes in brain.It is generally due to ischemia.
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,you 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.
You 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 you may need follow up MRI to see progression of lesions.
There is also old lacunae infarct in mid left centrum semi-ovale .
There is also an incidental
arachnoid cyst in left temporal region.It generally doesn't require any treatment.
Other findings like orbits,sinuses,mastoid air cells are normal.
Get well soon.
Take Care
Dr.Indu Bhushan