45 yo f mris: . 2009:3 foci of white matter hyperintensity. possible remote small vessel ischemia 2015:scattered areas of hyperintensity. concerning?

Hard to know: Radiologists are trained to report on images without knowing anything about a patient. This way, everything gets included; even findings that are normal for most people. For a person with family history of early onset dementia and cardiovascular disease, for example, these findings could be meaningful. You can consider a virtual c/s w/ neurologist to review the images and in context.