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MRI report revealed Innumerable T2 and FLAIR signal hyperintensities in the supratentorial white matter. What does this mean?

Nov 2013
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Practicing since : 1994
Answered : 5236 Questions
MRI - Brain

Technique: T1 sagittal, T1 and T2 axial. FLAIR axial, diffusion, SSH FFE EPI, FLAIR sagittal and FLAIR coronal images.

Findings: There are innumerable T2 and FLAIR hyperintensity signal
abnormalities demonstrated throughout the supratentorial white matter.
Lesions also noted in the right thalamic nucleus.

No abnormal lesions seen in the cerebellum or brainstem. Most of the lesions are oriented perpendicular to the corpus callosum.
There are no diffusion abnormalities. No extraaxial fluid collections.
No ventriculomegaly or hydrocephalus. No space-occupying intracranial mass. The central vascular flow voids are well demonstrated and unremarkable. No intrasellar or suprasellar abnormal mass No marrow signal abnormalities.

Impression: Innumerable T2 and FLAIR signal hyperintensities in the supratentorial white matter and right thalamic nucleus.
Differential diagnosis includes demyolinating process.


Pain has started two month ago in the left foot going up the leg to the hip area. Later up to the lower back and to the left arm. Then it went to the right
abdominal area and to the right arm. Even some parts of the face have been involved. The pain changes in areas some times more lower body then upper body,and tingling, numbness and a strange feeling of the skin comes and goes. The pain has increased from two up to ten.
I am 57 years old.
Posted Tue, 25 Jun 2013 in Brain and Spine
Answered by Dr. Sudhir Kumar 13 minutes later
Thank you for posting your query.

MRI brain findings are suggestive of differential diagnosis is lacunar infarcts (due to lack of blood flow to brain).

Since you have no traditional risk factors for lacunar infarcts (minor brain strokes due to small blood clots) such as high BP, sugar, cholesterol, smoking, etc, the most likely diagnosis in your case is MS (a demyelinating disorder).

Further investigations required to confirm the diagnosis include:
1. MRI spine,
2. Visual evoked potential,
3. Lumbar puncture with oligoclonal bands.

Initial treatment would be with steroid injections, and then disease modifying therapy would be required.

I hope it helps.
Please get back if you require any additional information.

Best wishes,

Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, Hyderabad,
My personal URL on this website:
My email: YYYY@YYYY
My blog:
Above answer was peer-reviewed by
Follow-up: MRI report revealed Innumerable T2 and FLAIR signal hyperintensities in the supratentorial white matter. What does this mean? 1 hour later
What could be the reason or cause for this problem? Could it be stress or other things?
Is there a cure or treatment for MS?

Thank you very much!
Answered by Dr. Sudhir Kumar 1 hour later
Thank you for getting back.

MS is an auto-immune disease, and the exact cause is unknown. It generally occurs in younger people (between 15-60 years of age).

Stress does not cause it, but can exacerbate it.

There are excellent treatments available for MS.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by
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