What does scattered althought predominantely bilateral frontal, subcortical white matter punctuate foci of signal abnormality mean?

Maybe nonspecific: If you have migraine, such white matter lesions are usually posterior, and if you had head trauma, the location may be more anterior, but both head and neck trauma could cause some increased foci. The demyelinating lesions of ms would be periventicular at right angles, but in the elderly such lesions might be c/w microvacular angiopathy, or even binwanger's.

Normal in most cases: This is a common finding on MRI brain. In most cases this could be a normal finding, however, history of migraine, smoking, dm and high cholesterol may increase risk for white matter lesions. You should seek a consultation with neurologist.