A high T2 signal on brain MRI is indicative of some lesion. It is common to see foci of chronic demyelination in the clinic. These chronic demyelinations are not particularly clinically significant because as we age, atherosclerosis manifests itself in the brain, and it shows up on MRI as chronic demyelination on the T2 image. If the lesions are more numerous, they may be associated with dementia, cognitive decline, etc. In addition to that, some patients with new infarcts will also show this high signal on the T2 image. So simply looking at the MRI, it is not possible to fully determine which condition is present. It is best to combine the patient’s clinical manifestations to determine the nature of the lesion, as well as the T1 image, FLAIR image, and DWI image.