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What Is Bilateral White Matter Disease ?
Question: what is Bilateral white matter disease or rather I had an MRI of my brain and the survey coverage of the included portions of paranasal sinuses and mastoids demonstrates focal right posterioer ethmold disease with complete opacification of posterieor ethmold air cells . Thereis evidence of inflammatory change posterior inferior left maxillary sinus. Hence bilateral white matter disease. Increased signal right posterior ethmoide and inferior left maxillary sinuses. to also conclude that I have spinal canal stenosis at the level of c5-c6 and c6-c7 Emg points to c7 level. can you explain more clearly what this means?
I have my mri disc but I cannot upload them however, I do have other health problems such as Arthitis (Osteo) the MRI of the cc-spine did reveal multiple disc bulges when he placed me on steroids to hopefully minimize the symptons of slowness of my thought process and the burning of the tongue did not improve my symptoms numbness of my right side of face, right arm and both legs and feet (like they fall asleep) however it's all the time. there is so much more with the symptons. The headaches are not a painful headache it like I have a hat on all the time and sometimes my vision will go blurry. Thank you hopefully I can get a better understanding, I believe I do understand but its been since 2010 with the diagnosis and from 2012 till the present time that I have been under the pain management. If I didn't have that I believe I would not be able to function. I retired early because I couldn't focus.Thank you, XXXXX
I have my mri disc but I cannot upload them however, I do have other health problems such as Arthitis (Osteo) the MRI of the cc-spine did reveal multiple disc bulges when he placed me on steroids to hopefully minimize the symptons of slowness of my thought process and the burning of the tongue did not improve my symptoms numbness of my right side of face, right arm and both legs and feet (like they fall asleep) however it's all the time. there is so much more with the symptons. The headaches are not a painful headache it like I have a hat on all the time and sometimes my vision will go blurry. Thank you hopefully I can get a better understanding, I believe I do understand but its been since 2010 with the diagnosis and from 2012 till the present time that I have been under the pain management. If I didn't have that I believe I would not be able to function. I retired early because I couldn't focus.Thank you, XXXXX
Brief Answer:
Bilateral white matter disease is due to ischemia.
Detailed Answer:
Hello XXXXXX,
I have thoroughly gone through your reports in detail.
In MRI(Brain),FLAIR or T2 weighted tiny hyper intensities less than five in number in deep white matter of brain or periventricular region can be ignored.
Mostly it is due to ischemic changes(decreased blood supply) that involves small blood vessels.However demyelination,post traumatic and post infective sequel should also be ruled out with follow up scans.Diabetes mellitus and vitamin B12 deficiency also aggravates the situation.
Hyper intensities more than five in number should be the cause of concern and it need investigations.
You need monitoring of conditions that leads to ischemic changes like hypertension,altered lipid profile,diabetes mellitus.
You need investigations like routine hemogram,RBS,LFT,RFT,Lipid profile,vitamin B12 estimation,ultrasound of abdomen.
If there is any more physical problems then it should be treated also.
You need follow up MRI (Brain)scan to see the progression of lesions.Demyelinating disorders are associated with many other neurological findings.You need clinical correlation.
You also have changes due to chronic sinusitis.It doesn't require any intervention.You only need control of sinusitis.You can take nasal steriods regularly.
You also have degenerative disc disease of cervial spine.
Degenerative changes occurs in spine due to aging and development of weakness in annulus fibrosis.
Due to degenerative changes , intervertebral disc herniation or bony overgrowth may lead to narrowing of central canal in spinal cord.
Majority of the cases of degenerative spine disease are benefited by physiotherapy.So,physiotherpay should be tried first.It causes strengthening of Para spinal muscles and it prevents further changes.
Surgery should be the last option.
There are also medicines like capsule pregabalin available for pain relief.
Treatment can be planned after consultation with neurosurgeon.
Get well soon.
Hope i have answered your query.
Further queries are most welcome.
Take Care
Dr.Indu XXXXXXX
Bilateral white matter disease is due to ischemia.
Detailed Answer:
Hello XXXXXX,
I have thoroughly gone through your reports in detail.
In MRI(Brain),FLAIR or T2 weighted tiny hyper intensities less than five in number in deep white matter of brain or periventricular region can be ignored.
Mostly it is due to ischemic changes(decreased blood supply) that involves small blood vessels.However demyelination,post traumatic and post infective sequel should also be ruled out with follow up scans.Diabetes mellitus and vitamin B12 deficiency also aggravates the situation.
Hyper intensities more than five in number should be the cause of concern and it need investigations.
You need monitoring of conditions that leads to ischemic changes like hypertension,altered lipid profile,diabetes mellitus.
You need investigations like routine hemogram,RBS,LFT,RFT,Lipid profile,vitamin B12 estimation,ultrasound of abdomen.
If there is any more physical problems then it should be treated also.
You need follow up MRI (Brain)scan to see the progression of lesions.Demyelinating disorders are associated with many other neurological findings.You need clinical correlation.
You also have changes due to chronic sinusitis.It doesn't require any intervention.You only need control of sinusitis.You can take nasal steriods regularly.
You also have degenerative disc disease of cervial spine.
Degenerative changes occurs in spine due to aging and development of weakness in annulus fibrosis.
Due to degenerative changes , intervertebral disc herniation or bony overgrowth may lead to narrowing of central canal in spinal cord.
Majority of the cases of degenerative spine disease are benefited by physiotherapy.So,physiotherpay should be tried first.It causes strengthening of Para spinal muscles and it prevents further changes.
Surgery should be the last option.
There are also medicines like capsule pregabalin available for pain relief.
Treatment can be planned after consultation with neurosurgeon.
Get well soon.
Hope i have answered your query.
Further queries are most welcome.
Take Care
Dr.Indu XXXXXXX
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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