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What Does The Brain MRI Report Indicate?

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Posted on Wed, 29 Apr 2015
Question: Recent MRI of brain findings show, "numerous scattered nonspecific white matter FLAIR hyperintense foci are present throughout the centrum semiovale and corona radiate. They are probably within the deep white matter. A few are subcortical. The largest in the posterior left frontal lobe measures 5mm. No enhancing lesions. No restricted diffusion".
I am 42 yrs old and my doctor wants to rule out MS. I have a medical hx for years of muscle spasms and pain that prevents me from walking at times, blur vision, extreme fatigue, memory fogginess, headaches, etc. Most recently I have been experiencing minor tremors when picking up objects which make my hands shake so badly that if it is a glass of water I am picking up I will spill half of it. Do the findings mean anything?
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Answered by Dr. Olsi Taka (59 minutes later)
Brief Answer:
MS is probable.

Detailed Answer:
I read your query carefully and I understand your concern.

Looking at that history of multiple white matter lesions and chronically accumulating neurological deficits the most probable diagnosis seems precisely MS. The fact your doctor suspected it means the clinical signs correspond as well.
At times a similar MRI picture may be related to changes of small blood vessels (but in older age) or infectious/inflammatory conditions but those have other associated signs or autoimmune conditions like lupus. So at your age MS is probable.
Another option would also be neurosarcoidosis looking at your history. Its white matter lesions can be indistinguishable from MS, but usually enhance after contrast and involve other structures like meninges, cranial nerves so less likely.
However due to your history and because there miss some elements of MS (enhancing of some lesions after contrast, corpus callosum and periventricular lesions) your doctor might want to order spine MRI and a spinal tap to look for changes related to MS called oligoclonal bands to confirm diagnosis.

I remain at your disposal for further questions.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Olsi Taka

Neurologist

Practicing since :2004

Answered : 3673 Questions

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What Does The Brain MRI Report Indicate?

Brief Answer: MS is probable. Detailed Answer: I read your query carefully and I understand your concern. Looking at that history of multiple white matter lesions and chronically accumulating neurological deficits the most probable diagnosis seems precisely MS. The fact your doctor suspected it means the clinical signs correspond as well. At times a similar MRI picture may be related to changes of small blood vessels (but in older age) or infectious/inflammatory conditions but those have other associated signs or autoimmune conditions like lupus. So at your age MS is probable. Another option would also be neurosarcoidosis looking at your history. Its white matter lesions can be indistinguishable from MS, but usually enhance after contrast and involve other structures like meninges, cranial nerves so less likely. However due to your history and because there miss some elements of MS (enhancing of some lesions after contrast, corpus callosum and periventricular lesions) your doctor might want to order spine MRI and a spinal tap to look for changes related to MS called oligoclonal bands to confirm diagnosis. I remain at your disposal for further questions.