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Suggest Treatment For Lesions In Frontal And Parital Lobes
Question: I have lesions in my frontal and parital lobes that the radiologist said was not a demyliating (ms) type. I have severe cognitive impairment that warrented the mri.
I have researched it quite a bit and found that i have a few risk factors for a silent stroke like severe speep apnea, pcos, hypertension, metabolic syndrome, and i ocasionally smoke cigerettes. I have also read that silent strokes cause vascular dementia. How would a neurologist know if thats what caused it and if it is that is it degenerative even if i dont have anymore strokes?
I have researched it quite a bit and found that i have a few risk factors for a silent stroke like severe speep apnea, pcos, hypertension, metabolic syndrome, and i ocasionally smoke cigerettes. I have also read that silent strokes cause vascular dementia. How would a neurologist know if thats what caused it and if it is that is it degenerative even if i dont have anymore strokes?
Brief Answer:
Further investigations would help.
Detailed Answer:
Hi,
Thank you for getting back and posting your query.
I have noted your symptoms as well as MRI findings.
In your case, first of all, we need to confirm the severity of cognitive impairment, as well as identify the domains of cognitive function loss. This can be done by a detailed neuro-psychological testing.
The above information can be analysed along with MRI brain findings to see if all your cognitive impairment can be explained by the MRI lesions or not. This is because MRI gives information about the brain "structure" and not much about the brain "functions".
If there is a mismatch between the MRI findings and cognitive dysfunction, then, further investigations such as functional MRI of brain, PET scan of brain, etc would help.
Regarding differentiating between vascular and degenerative forms of dementia, one of the scores used by us is called "Hachinsky ischaemic score". A score of 7 or more on this predicts vascular dementia.
I hope my reply has helped you.
I would be pleased to answer, if you have any follow up queries or if you require any further information.
Best wishes,
Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, XXXXXXX
For DIRECT QUERY to me: http://bit.ly/Dr-Sudhir-kumar
My blog: http://bestneurodoctor.blogspot.com/
Further investigations would help.
Detailed Answer:
Hi,
Thank you for getting back and posting your query.
I have noted your symptoms as well as MRI findings.
In your case, first of all, we need to confirm the severity of cognitive impairment, as well as identify the domains of cognitive function loss. This can be done by a detailed neuro-psychological testing.
The above information can be analysed along with MRI brain findings to see if all your cognitive impairment can be explained by the MRI lesions or not. This is because MRI gives information about the brain "structure" and not much about the brain "functions".
If there is a mismatch between the MRI findings and cognitive dysfunction, then, further investigations such as functional MRI of brain, PET scan of brain, etc would help.
Regarding differentiating between vascular and degenerative forms of dementia, one of the scores used by us is called "Hachinsky ischaemic score". A score of 7 or more on this predicts vascular dementia.
I hope my reply has helped you.
I would be pleased to answer, if you have any follow up queries or if you require any further information.
Best wishes,
Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, XXXXXXX
For DIRECT QUERY to me: http://bit.ly/Dr-Sudhir-kumar
My blog: http://bestneurodoctor.blogspot.com/
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
My symptoms are short term and working memory loss, confusion at times, trouble paying attention and concentrating, unable to organize thoughts or actions, unable to problem solve, unable to follow directions ie; cant seem to follow recipes without screwing something up. Do these symptoms go with frontal and parital lobe lesions? P.S. I am only 33 .
Brief Answer:
Yes, they do.
Detailed Answer:
Thank you for getting back.
These symptoms do point to involvement of frontal and parietal lobes, however, the severity (mild, moderate or severe) of impairment in these cognitive domains need to confirmed by detailed neuro-psychological testing.
Also, formal testing of memory may reveal involvement of temporal lobes too, as recent memory is stored there.
These lobes (frontal and parietal) have varied functions, and not all functions of frontal and parietal lobes may get affected in a person; so, the formal testing may reveal preservation of certain cognitive functions too.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Yes, they do.
Detailed Answer:
Thank you for getting back.
These symptoms do point to involvement of frontal and parietal lobes, however, the severity (mild, moderate or severe) of impairment in these cognitive domains need to confirmed by detailed neuro-psychological testing.
Also, formal testing of memory may reveal involvement of temporal lobes too, as recent memory is stored there.
These lobes (frontal and parietal) have varied functions, and not all functions of frontal and parietal lobes may get affected in a person; so, the formal testing may reveal preservation of certain cognitive functions too.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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