Hi and welcome,
"There are punctate 1mm white matter lesions along the genu of the internal capsules"
On a radiology report this is often stated as 'punctate foci' which means two or more small-tiny-microscopic sized lesions, typically anything 1- 3mm is unmeasured and falls under ths terms. So this part of your report is saying you have an unspecified number of micro sized (1mm) lesions located deep within the subcortical white matter, the 'genu' is 1 of the 5 parts that make up the internal capsule.
"The internal capsule is a deep subcortical structure that contains a concentration of white matter projection fibres. These fibres form the corona radiata. Anatomically, this is an important area because of the high concentration of both motor and sensory projection fibres" https://radiopaedia.org/articles/internal-capsule
I was going to attempt to explain the individual details of your MRI report but to be honest this is the type of report that requires explanation by your neurologist so he/she can draw relevance to your specific clinical symptoms and any diagnostic significance, so i'm going to recommend you don't get bogged down in trying to understand the details of your report and instead ask your neurologist to explain the big picture of what this all means to you and your situation...
Sorry i couldn't be on more help......JJ
I'm the MS community leader and your MRI report doesn't read with the types of things we'd typically be seeing on an MS related MRI report, mini strokes or TIA's don't usually leave any evidence behind and because your in your early 50's ischaemic white matter disease is 15+ years too early to be normal age related.....your report is mentioning the circle of willis eg "Anatomic variation of the circle of Willis is a dominant anterior circulation and diminutive vertebrobasilar system" so i'm actually thinking because the Cycle of Willis unites the internal carotid and vertebrobasilar system which maintains the stability of blood supply to the brain, your results 'maybe' suggestive of an unusual vascular variant which is likely developmental but might make sense of these results and the types of issues your now dealing with in your 50's, your neuro is the best person to explain it though.
I hope you get your answers next week......JJ