in this gentleman does not seem to be related to any of the findings on the scan. The chronic infarct means that at some time in the past he has had a minor stroke
which he may or may not have even noticed. the rest of the changes are suggestive of shrinking of the brain which can occur with age. Therefore, both these are not the cause of the headaches. If there are no contraindications, he should be on a medicine like aspirin
to prevent strokes in the future.
Hope this helps.