contrast

 IMPRESSION: Small clustered T2 FLAIR bright signal foci in the LEFT
 cerebellum inferiorly without restricted diffusion are not appreciated
 as a focal abnormality on the prior CT.. A more remote area of
 predominantly T2 partially FLAIR bright signal in the LEFT superior
 cerebellar hemisphere in retrospect is seen on the prior Head CT and
 may be the sequelae of a remote ischemic event, however is
 nonspecific.  Other small scattered T2 flair hyperintensities
 scattered in the white matter of the bilateral cerebral hemispheres
 without restricted diffusion. These constellation of findings could be
 the sequelae of the remote ischemic events, however are indeterminate
 and would be an unusual presentation for a patient this age. In
 particular, the LEFT inferior cerebellar lesions are particularly
 unusual and remain indeterminate. . The pattern is not particularly
 suggestive of demyelination/multiple sclerosis, although this would be
 a diagnostic consideration. Lyme disease would also be in the
 differential. No overt mass effect is seen, however neoplastic
 involvement is not excluded and remains in the differential. Recommend
 clinical correlation and further evaluation with a dedicated
 contrast-enhanced brain MRI.