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I Just Had A Brain MRI . It States Findings:
Question: I just had a brain MRI. It states findings: cerebral parenchyma, small bilateral peripheral micro hemorrhages throughout brain, vascular: major intracranial flow voids are present. Was wondering if someone could explain my results to me.
Brief Answer:
There are small bleeding areas in the brain, but the blood flow in the brain's blood vessels is normal
Detailed Answer:
Hello and welcome to "Ask a Doctor" service,
I carefully read your query and understand your concern.
MRI is one of the best examinations to evaluate the brain and the blood vessels there.
In your case, the findings and explanations in detail are:
- cerebral parenchyma means the brain itself
- small bilateral peripheral microhemorrhages means that there are small bleeding areas in the periphery of the brain on both sides (bilateral, left and right side).
- major intracranial flow voids are present means that the main arteries in the brain have good blood flow
To conclude:
- there are small bleeding areas in the brain on both sides but generally, the blood flow in the main blood vessels is normal.
I hope this answers your query.
I remain at your disposal for further medical assistance.
Regards,
Dr. Antoneta Zotaj
General and Family Physician
There are small bleeding areas in the brain, but the blood flow in the brain's blood vessels is normal
Detailed Answer:
Hello and welcome to "Ask a Doctor" service,
I carefully read your query and understand your concern.
MRI is one of the best examinations to evaluate the brain and the blood vessels there.
In your case, the findings and explanations in detail are:
- cerebral parenchyma means the brain itself
- small bilateral peripheral microhemorrhages means that there are small bleeding areas in the periphery of the brain on both sides (bilateral, left and right side).
- major intracranial flow voids are present means that the main arteries in the brain have good blood flow
To conclude:
- there are small bleeding areas in the brain on both sides but generally, the blood flow in the main blood vessels is normal.
I hope this answers your query.
I remain at your disposal for further medical assistance.
Regards,
Dr. Antoneta Zotaj
General and Family Physician
Above answer was peer-reviewed by :
Dr. Raju A.T
Thank you for your response. For some reason I received two different responses from two different Drs and they may contradict each other. Are you able to look into both responses and clarify for me please? Thank you so much
One other question if you don’t mind... are these micro hemorrhages something that can be treated or resolve as I do not have diabetes and have never had high blood pressure as the other Dr stated. Atherosclerosis I don’t know. Am I at risk of a larger hemorrhage or stroke?
Brief Answer:
Detailed answer below
Detailed Answer:
Hello and welcome back,
I carefully checked your reply and also the response of the other doctor.
There are two types of microhemorrhages. The ones that are related to hypertension, which develop in patients with high blood pressure and generally are deeper microhemorrhages, and the ones that are not related to hypertension. The last group does not happen in the terrain of hypertension and tends to be more superficial (peripheral) compared to the ones related to hypertension.
So, in your case, given that you do not have hypertension and the bleeding lesions are not deep but peripheral, very likely you have the non-hypertensive variant.
The non-hypertension microhemorrhages are thought to be due to small vessel abnormalities. Their nature is not well understood but some suggest that there may be a kind of protein that deposits in these small vessels in the brain (amyloid) and that causes these vessels to break easier and bleed.
The clinical importance of these microbleeds varies in different populations, with age and depends also if the patient has symptoms or not.
There are many healthy patients, that have these microbleeds but no symptoms and there is nothing to worry about them, just need monitoring. This happens in elderly patients.
In some populations these lesions are more common than in others as well, not much understood why.
Also, if you have symptoms or not, this is a crucial factor to determine the importance of these lesions.
To conclude:
- there are two variants of microhemorrhages in the brain
- the peripheral ones (as it is in your case) are generally due to the structure of the small blood vessels and the deep ones are due to hypertension
- the peripheral microbleeds can be found in certain populations and in elderly and not signify any serious condition unless the patient has symptoms related to them
- in the case of the superficial bleeds, the treatment is tricky because giving blood thinners in them may worsen the bleeds and increase their severity and number. So, the doctor needs to individualize the treatment and follow up very carefully in your case.
- studies show that patients with microhemorrhages are at increased risk for stroke, this is why you need to have regular follow up to check if you develop high blood pressure or diabetes and treat them on time. You will need a healthy lifestyle (normal weight, healthy diet, no smoking, no alcohol, and keeping active).
- small microbleeds may cause short neurological symptoms that last less than 24 hours and rarely more stable symptoms, but in time may cause the patient to lose cognition (critical thinking, memory, etc) and develop dementia, so regular checks and monitoring with your doctor is important.
I hope this answers your query.
I remain at your disposal for further medical assistance.
Regards,
Dr. Antoneta Zotaj
General and Family Physician
Detailed answer below
Detailed Answer:
Hello and welcome back,
I carefully checked your reply and also the response of the other doctor.
There are two types of microhemorrhages. The ones that are related to hypertension, which develop in patients with high blood pressure and generally are deeper microhemorrhages, and the ones that are not related to hypertension. The last group does not happen in the terrain of hypertension and tends to be more superficial (peripheral) compared to the ones related to hypertension.
So, in your case, given that you do not have hypertension and the bleeding lesions are not deep but peripheral, very likely you have the non-hypertensive variant.
The non-hypertension microhemorrhages are thought to be due to small vessel abnormalities. Their nature is not well understood but some suggest that there may be a kind of protein that deposits in these small vessels in the brain (amyloid) and that causes these vessels to break easier and bleed.
The clinical importance of these microbleeds varies in different populations, with age and depends also if the patient has symptoms or not.
There are many healthy patients, that have these microbleeds but no symptoms and there is nothing to worry about them, just need monitoring. This happens in elderly patients.
In some populations these lesions are more common than in others as well, not much understood why.
Also, if you have symptoms or not, this is a crucial factor to determine the importance of these lesions.
To conclude:
- there are two variants of microhemorrhages in the brain
- the peripheral ones (as it is in your case) are generally due to the structure of the small blood vessels and the deep ones are due to hypertension
- the peripheral microbleeds can be found in certain populations and in elderly and not signify any serious condition unless the patient has symptoms related to them
- in the case of the superficial bleeds, the treatment is tricky because giving blood thinners in them may worsen the bleeds and increase their severity and number. So, the doctor needs to individualize the treatment and follow up very carefully in your case.
- studies show that patients with microhemorrhages are at increased risk for stroke, this is why you need to have regular follow up to check if you develop high blood pressure or diabetes and treat them on time. You will need a healthy lifestyle (normal weight, healthy diet, no smoking, no alcohol, and keeping active).
- small microbleeds may cause short neurological symptoms that last less than 24 hours and rarely more stable symptoms, but in time may cause the patient to lose cognition (critical thinking, memory, etc) and develop dementia, so regular checks and monitoring with your doctor is important.
I hope this answers your query.
I remain at your disposal for further medical assistance.
Regards,
Dr. Antoneta Zotaj
General and Family Physician
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Brief Answer:
It is my pleasure to assist you
Detailed Answer:
Hello and welcome back,
It is my pleasure to assist you.
I wish you good health.
I remain at your disposal for further medical assistance.
Regards,
Dr. Antoneta Zotaj
General and Family Physician
It is my pleasure to assist you
Detailed Answer:
Hello and welcome back,
It is my pleasure to assist you.
I wish you good health.
I remain at your disposal for further medical assistance.
Regards,
Dr. Antoneta Zotaj
General and Family Physician
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Thank you so much. I appreciate your help.
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