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Brain mri done. What are the findings in the report and required treatment?

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Practicing since : 1974
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My mom just had an MRI done on her brain. I don't understand the results given. Here are some key words:
mild & cortical atrophy questionable lesion in right anterior perfivenpricular white matter seen on axial images 14. Minimally inhomagenous lesion settled with increased signal intensity , T2 weighted images. Low signal intensity on flair. No abnormal diffusion, no obvious abnormality on gradient echo image sinus disease. Impression - non specific perifventriculrar lesion. She is getting another MRI done.
What is this and what caused it? Is it treatable? She went into ER after her bp went up past 200. Pls help. thank you
Posted Fri, 15 Feb 2013 in Brain and Spine
Answered by Dr. Pratap Sanchetee 1 hour later

I have seen the description and history given by you for your mother.

Cortical atrophy and other lesions described on MRI have following two means:

1) Age related changes: Brain has become slightly smaller (atrophy) due to age related processes. They are not related to any functional changes and does not require any specific treatment.

2) Because of hypertension these age related changes have come up earlier. They also are not related to any functional changes.

The best approach for your mother will be:

1 Control of BP with appropriate drugs
2: Life style modification and meditation/yoga
3: Assessment of risk factors: diabetes, lipid profile, smoking, alcohol etc and treatment if they are present.

Let me know if you need further clarifications.

Above answer was peer-reviewed by
Follow-up: Brain mri done. What are the findings in the report and required treatment? 16 hours later
Thank you doctor. So based on what you are saying it's nothing dangerous? Could it lead to aneuryms or stroke? The doctor did put her on blood pressure medicine but she measures her blood pressure daily and although some days are a bit high, it's been pretty normal. She is doing another MRI (with contrast) to see if they can see more. The first MRI came back with 50/50 results.
The doctor at the hospital said it *could* be XXXXXXX if untreated.
Please help, i am so worried and scared. thank you so much
Answered by Dr. Pratap Sanchetee 17 hours later

MRI findings by itself are not XXXXXXX or could lead to aneurysm. It is underlying disorder (if any) which decides its outcome. So your doctor would do do few tests to determine underlying risk factors and disease. Treatment will based on results of investigations.

These findings on MRI are associated with increased risk for stroke or dementia but it is not a big adverse factor and one need to approach the situation with calm.

Above answer was peer-reviewed by
Follow-up: Brain mri done. What are the findings in the report and required treatment? 11 hours later
Thank you doctor. That helps a lot. One last thing. She went into the hospital with high blood pressure of 208/105 and high heart rate. This was right after she had a pain shot in her neck. Before this shot, she never had any issues with high blood pressure other than a few days where it was in the 140's. The same thing happened about 3-4 years ago when she got a shot in her back.
Could this be a result of her being allergic to the medication given from the shot since they found nothing wrong with her heart or her brain?
Just looking into some insight as to why her bp would spike up like that for no reason other than the recent medical shot she rec'd.
Thanks again. Your answers really helped out and I really like this service.
Thanks again doctor.
Answered by Dr. Pratap Sanchetee 13 hours later

Nice to know that my explanation on your query has solved some of your doubts.

People who are hypertensive or have a tendency of hypertension, BP often rises with anxiety, pain or any other discomfort. This rise is often transient and BP comes down significantly ( may not be normal range) after some times. It is unlikely due to presumed allergy to drugs.

Regards and good wishes

Above answer was peer-reviewed by
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