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Diagnosed with major depressive disorder. Having memory and concentration issues. What does the brain MRI mean?

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Answered by
Practicing since : 2001
Answered : 12749 Questions
Hi Doc Grief:

I was diagnosed with major depressive disorder in 1995, now classified as severe. I've been having some memory, concentration, and attention span issues. I'm currently taking 40 mg amphetamine salts, 40 mg Fluoxetine and 200 mg bupropion HCI SR daily. My doctor ordered a brain MRI w/o contrast this week. Today I got a copy of the radiology report of which my doctor said is not completely normal and recommends I see neurology next. This is what the report says:
1. Several punctate signal abnormalities identified in the deep matter frontal lobes bilaterally. These finding are nonspecific but most likely related to prior small vessel ischemic change or prior inflammatory process. No evidence of acute intracranial event/infarct. 2. Rounded CSF-intensity mass posterior fossa consist with arachnoid cyst.

BTW, I'm male, a retired veteran, and just turned 50. I also have sleep apnea and use a CPAP . Is this radiology report above possibly related to my major depressive disorder or sleep apnea? Should I be concerned? Any opinion of what that radiology report means in laymen terms would be appreciated. Thank you!

Posted Fri, 1 Nov 2013 in Men's Health
Answered by Dr. Rakhi Tayal 59 minutes later
Brief Answer:
Minor findings. Not worrisome.

Detailed Answer:
Thanks for trusting us with your health concern.
The multiple small white matter lesions that have been discovered on your MRI represent ischemia (lack of blood flow) in the small blood vessels of the brain. They are also at times referred to as ischemic small vessel disease. These lesions are more commonly seen in the MRI of patients who have cerebrovascular risk factors like hypertension, diabetes and high cholesterol as well those that smoke. Their incidence increases with age.
These are related to major depression or sleep apnea that you are having.
These lesions are responsible for memory impairment (vascular dementia) in some individuals. A neurological examination to look for cognitive impairment is needed to diagnose the condition.
The arachnoid cyst that has been detected is a benign swelling and is not worrisome unless very large in size.
These are all minor changes that need a follow up MRI scan after 6 months to see the progress.
Please feel free to discuss further. I will be glad to answer the follow up queries that you have.
Wishing you good health.
Dr. Rakhi Tayal.
Above answer was peer-reviewed by
Follow-up: Diagnosed with major depressive disorder. Having memory and concentration issues. What does the brain MRI mean? 11 minutes later
Hello Dr. XXXXXXX Tayal,

Thank you for your prompt opinion. I have previously provided you with a quoted "impression" from the radiology report. While I was waiting for an answer from a doctor, I already received your reply when I was trying to upload the pdf file for the complete radiology report.

Please review report findings from the provided uploaded file. Any other comment or opinion toward the whole completed report?

Thank you.


Answered by Dr. Rakhi Tayal 18 minutes later
Brief Answer:
The opinion is same.

Detailed Answer:
Thanks for writing again.
I have seen the complete uploaded report. The findings are not worrisome but needs an opinion by a neurologist for any neurological deficit and a follow up scan to see the progression of these lesions.
Hope my answer is helpful.
If you do not have any clarifications, you can close the discussion and rate the answer. Wish you good health.
Above answer was peer-reviewed by
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