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What Do These MRI Findings Indicate?
Question: I just got an mri of my brain and brain stem. The report says:
1. few small foci FLAIR hyperintensity in the cerebral white matter are nonspecific but may represent mild chronic microvascular ischemic changes.
2. Stable probable small arachcnoid cyst along the posterior margin of the right cerebellum.
3. asymmetric prominmence of the extra-axial space overlying the left cerebral hemisphere and left cerebellum probably represent chronic subdural collections of subdural hygromas. stable mild left to right midline shift.
mild cerebral volume loss and cerebellur loss with associated mild ventricular dilatation. no evidence of acute infarct
no low gradient signal to suggest old blood products
foci FLAIR hyperintensity in the subcortical and periventricular white matter are nonspecific but may represent mild chronic microvascular changes
prominence of the right posterior extra-axial space along the posterior margin of the right cerebellum
that prpobably represents a small arachnoid cyst which is stable
there is asymmetric prominence of the extra-axial space overlying the left cerebral hemisphere and left cerebellum that may be due to chronic subdural collections or subdural hygomas.
no fluid levels in paranasal sinuses
major intracranial flow-voids are preserved
I am 53 years old have a history of falls (I have been diagnosed with ataxia) with head injuries. I am bipolar with major depressive disorder, anxiety, ADHD and BPD. I was in a car accident in 2009 where I lost consciousness for about a minute. I have taken extensive neuropsychiatric exams, an MMPI . Had 3 previous mris and neuropsych testing. with neuropsyche testing shows decline and improvement in different areas between those tests. mris have shown that the cyst has increased slightly in size. I have been having memory problems since the Accident in 2009 and they have progressively gotten worse., especially in the last year. My ataxia has gotten worse, I fall an average 1-2 times a week now with almost falls about 3-4 times a day. I have been diagnosed with b12 deficiency, since gotten better. I have hada a few different diagnosis. cerrebelar ataxia, mild cognitive disorder and a nonspecific movement disorder with myoclonus and tremors and the ataxia. I also have severe fibromyalgia and nerve muscle damage.
I am having trouble with my vision blurring and have have been diagnosed with dysphagia (trouble swallowing) type III. I quit smoking a year ago after having smoked for over 30 years. I have extensive hearing loss in my left ear and mild loss in my right ear. My blood pressure generally runs about 80/60 and 90/50. My pulse is about 50-53 bpm. and my pulse ox generally runs about 90 percent. I had lazicks surgery in 2005 to correct nearsightedness. A recent eye exam has indicated that I am going to need to either get glasses or have another lasiks procedure. I have to wear prescription reading glasses I have gained about 25 pounds in the last 6 months and am constantly hungry and thirsty. My neurologist is considering a PET scan and a possible spinal tap. I have also just recentlhy had blood draw for genetic testing, no results as of this writing.
Please advise.
XXXXXXX
Please advise
1. few small foci FLAIR hyperintensity in the cerebral white matter are nonspecific but may represent mild chronic microvascular ischemic changes.
2. Stable probable small arachcnoid cyst along the posterior margin of the right cerebellum.
3. asymmetric prominmence of the extra-axial space overlying the left cerebral hemisphere and left cerebellum probably represent chronic subdural collections of subdural hygromas. stable mild left to right midline shift.
mild cerebral volume loss and cerebellur loss with associated mild ventricular dilatation. no evidence of acute infarct
no low gradient signal to suggest old blood products
foci FLAIR hyperintensity in the subcortical and periventricular white matter are nonspecific but may represent mild chronic microvascular changes
prominence of the right posterior extra-axial space along the posterior margin of the right cerebellum
that prpobably represents a small arachnoid cyst which is stable
there is asymmetric prominence of the extra-axial space overlying the left cerebral hemisphere and left cerebellum that may be due to chronic subdural collections or subdural hygomas.
no fluid levels in paranasal sinuses
major intracranial flow-voids are preserved
I am 53 years old have a history of falls (I have been diagnosed with ataxia) with head injuries. I am bipolar with major depressive disorder, anxiety, ADHD and BPD. I was in a car accident in 2009 where I lost consciousness for about a minute. I have taken extensive neuropsychiatric exams, an MMPI . Had 3 previous mris and neuropsych testing. with neuropsyche testing shows decline and improvement in different areas between those tests. mris have shown that the cyst has increased slightly in size. I have been having memory problems since the Accident in 2009 and they have progressively gotten worse., especially in the last year. My ataxia has gotten worse, I fall an average 1-2 times a week now with almost falls about 3-4 times a day. I have been diagnosed with b12 deficiency, since gotten better. I have hada a few different diagnosis. cerrebelar ataxia, mild cognitive disorder and a nonspecific movement disorder with myoclonus and tremors and the ataxia. I also have severe fibromyalgia and nerve muscle damage.
I am having trouble with my vision blurring and have have been diagnosed with dysphagia (trouble swallowing) type III. I quit smoking a year ago after having smoked for over 30 years. I have extensive hearing loss in my left ear and mild loss in my right ear. My blood pressure generally runs about 80/60 and 90/50. My pulse is about 50-53 bpm. and my pulse ox generally runs about 90 percent. I had lazicks surgery in 2005 to correct nearsightedness. A recent eye exam has indicated that I am going to need to either get glasses or have another lasiks procedure. I have to wear prescription reading glasses I have gained about 25 pounds in the last 6 months and am constantly hungry and thirsty. My neurologist is considering a PET scan and a possible spinal tap. I have also just recentlhy had blood draw for genetic testing, no results as of this writing.
Please advise.
XXXXXXX
Please advise
Brief Answer:
Need to rule out high cerebrospinal pressure, infection. You can go for LAS
Detailed Answer:
Hi XXXXXXX
Thanks for the query.
Could you tell me what Medicine you are taking?
Are you able to walk without support?
Are you getting your blood pressure monitored regularly?
I have read and acknowledged your problems. I can understand how difficult it is for you.
Your Doctor is suspecting a rise in the pressure in your brain due to decreased drainage of the cerebrospinal fluid.
It is advisable to get the lumbar tap done and also to look for infection.
You can go for the LASIK Surgery for your eye to help with the vision.
I hope I have answered your query.
Kindly respond to my queries for me to be in a better position to help you.
Regards,
Dr. Aashish Raghu
Need to rule out high cerebrospinal pressure, infection. You can go for LAS
Detailed Answer:
Hi XXXXXXX
Thanks for the query.
Could you tell me what Medicine you are taking?
Are you able to walk without support?
Are you getting your blood pressure monitored regularly?
I have read and acknowledged your problems. I can understand how difficult it is for you.
Your Doctor is suspecting a rise in the pressure in your brain due to decreased drainage of the cerebrospinal fluid.
It is advisable to get the lumbar tap done and also to look for infection.
You can go for the LASIK Surgery for your eye to help with the vision.
I hope I have answered your query.
Kindly respond to my queries for me to be in a better position to help you.
Regards,
Dr. Aashish Raghu
Above answer was peer-reviewed by :
Dr. Prasad
HAVE YOU RECeived the answers to your questions from me, along with additional details of my symptoms?
Please let me know
Medicines I am taking:
PRAVASTATIN NA 20MG
CARBIDOPA 25/LEVODOPA 100MG
OMEPRAZOLE 20MG EC CAP
GABAPENTIN 600MG TAB
ETODOLAC 300MG CAP
TRAZODONE HCL 100MG
LIDOCAINE ointment
MEMANTINE HCL 5MG
LAMOTRIGINE 150MG
SERTRALINE HCL 100MG
TROSPIUM CL 20MG
METHOCARBAMOL 750MG
METHADONE 5MG
OXYCODONE HCL 10MG
CYANOCOBALAMIN 1000MCG/ML INJ
I can walk short distances as long as I have something to hold onto. I can ambulate (depending on distance I have to go) with Forearm crutches or a walker.
I am in a wheelchair 75% of the time and this amount has gradually increased. I have been using the chair for 1 year...
My blood pressure and pulse rate have been low for the last year or so.
I often close one eye or the other without realizing I am doing it (my friends tell me and I notice it sometimes when things I am looking at start doing squirrelly things. It hurts to look down without moving my neck. It hurts to look up without moving my neck.
I have had night sweats for the past 6 months (I am going thru menopause started 6 months ago)
I am extremely sensitive to cold.
I have numbness in my toes.
I drop things a lot...it just seems I lose grip, nothing numb.
I usually sleep 4-6 hours a night. No trouble falling asleep, just staying asleep
I have started having severe headaches on a more frequent basis (I have always had headaches my adult life. At times they are very bad, I have to lay in bed with an ice pack dark and quiet for several hours. (I drink about 128 oz of water a day)
I broke my nose with my last fall. (seems to be healing ok)
I have urinary incontinence (stress) and trouble starting and stopping my urine stream
I bruise more easily and wounds take longer to heal.
As far as cognitive....I have trouble finding words, my speech pattern has changed (I stutter and halt, something my family and friends have noticed), I leave out or flip letters and numbers. My handwriting varies, sometimes is very tiny and sometimes is large. I have trouble spelling. I was an honors student in high school and had a tested IQ of 157 when I was 8 years old. No recent evaluation.
I have my last 2 brain studies on disc but cannot figure out how to load them.
I live in XXXXXXX and have for the last 12 years.
I have a dog who I got 1 year ago and I wash my hands thoroughly after playing with her and after I use the restroom (I was a chef before I got injured, so the hand-washing is kind of second nature)
I do have a lesion on my lower leg that has healed after a year of treatment.(It still comes and goes which is really weird) There is no pattern to it getting worse after doing any activity or using any type of new lotion and such.
I don't have a problem knowing what people are saying to me, but I do sometimes have to ask something to be explained over again, sometimes it has to be explained a third time.
Sorry to throw so much info at you, but I wanted to give you as much info as I could. I am wondering though, how could it be a possible infection if the change from my MRI in 2013 and this recent one are slightly different and no infection showed last one (I have a new neurologist who ordered all these tests, could she have suspected something my last one didn't?)
Update:
I saw my neurologist today and she recommended I get a paraneoplastic panel to see if I have a functional neuro disorder and to rule out cerebellar ataxia and also a spinal mri of my mid spine.
Symptoms consistent with both conversion and somatization disorders
Recommend stopping memantine for 3-5 months to see if cognitive decline.
The results of the genetic panel:
Test was for:
ApoE Genotype
Result:
E3 / E4
Comments:
ApoE4 Carrier: associated with increased CVD risk. (Note: I do have high cholesterol being treated with Prevastatin
What does this mean?
Doc said it was that I have a higher than normal chance of developing Altzheimer’s than average
Brief Answer:
Cerebellar ataxia possible
Detailed Answer:
Thanks for the follow up query.
Yes, Since you have increased ApoE, you may tend to retain cholesterol in your system than expel it in the bile. This could put you at risk for Hypercholesterolaemia and Alzheimer's disease. You must eat low fat diet to reduce the risk.
Cerebellar ataxia can affect the balance and fine movements of the hands which is a probable diagnosis and an MRI may also indicate the same if present. Somatisation is also probable if you feel the inner workings of your body being magnified and terrifying to you. Usually such patients complain that the food they eat of being pushed into their brain and they can feel the food being digested there. This is just an example.
Kindly get the required tests and keep me informed.
Cerebellar ataxia possible
Detailed Answer:
Thanks for the follow up query.
Yes, Since you have increased ApoE, you may tend to retain cholesterol in your system than expel it in the bile. This could put you at risk for Hypercholesterolaemia and Alzheimer's disease. You must eat low fat diet to reduce the risk.
Cerebellar ataxia can affect the balance and fine movements of the hands which is a probable diagnosis and an MRI may also indicate the same if present. Somatisation is also probable if you feel the inner workings of your body being magnified and terrifying to you. Usually such patients complain that the food they eat of being pushed into their brain and they can feel the food being digested there. This is just an example.
Kindly get the required tests and keep me informed.
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.
Above answer was peer-reviewed by :
Dr. Prasad
Answered by
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