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MRI of brain shows few lacunar ischaemic foci in bilateral cerebral hemispheres. Possible cure and precautions ?

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We have got the MRI of my mother done today and the report is as under:- Protocol: Multiplanar MRI of the brain done on 1.5 Tesla machine was performed using T1 weighted gradient echo, T2 weighted fast spin echo & fast FLAIR sequences. Observations: Few lacunar hyperintense foci are seen in the bilateral fronto-parietal white matter on FLAIR images. No other area of altered signal seen in the cerebral parenchyma, brainstem and cerebellum. Ventricles are normal in size and morphology. The sulci and cisterns are unremarkable. No significant shift of midline structures is seen. Intracranial vessels and dural sinuses display the expected flow void. The craniovertebral junction is unremarkable. Conclusion: Few lacunar ischaemic foci in the bilateral cerebral hemispheres. We are consulting our doctor on this issue on monday 07/11/11 but in the meantime well appreciate to know more details about this report and whatever cure possible for this sickness and what precautions we should take in this.
Posted Thu, 26 Apr 2012 in Brain and Spine
Answered by Dr. Rakhi Tayal 7 hours later
Thanks for posting your query.
I have read your problem with concern and also noted the medication that your mother is currently on.
Few lacunar hyperintense foci in the white matter do not have any clinical significance in most of the cases if there are no associated signs and symptoms related to cognitive or behavioural deficit.

"All white matter lesions do not represent a disease".

The lesions found in your mother's case are non progressive and are more indicative of a benign chance finding. In the absence of any clinical signs and symptoms, the significance of these white hyperintense lesions are difficult to assess.

A lot of work has been done to determine the significance of white matter lesions. The thinking now is that they represent ischemia (lack of blood flow) in the small blood vessels of the brain. Hence they are also at times referred to as ischemic small vessel disease. Hence 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 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.

Hence I advise you to go ahead with your appointment with your neurologist. He would be the best person to guide further diagnostic workup and treatment.
Right now without a proper examination it is inappropriate to suggest any treatment or precautions.
Hope this answers your query. I will be glad to answer the follow up queries that you have.
Wishing you good health.
Above answer was peer-reviewed by
Follow-up: MRI of brain shows few lacunar ischaemic foci in bilateral cerebral hemispheres. Possible cure and precautions ? 5 hours later
I would like to get opinion from a neurologist or a psychiatrist like Dr. U. Gauthamadas on this report. Please help.
Answered by Dr. Rakhi Tayal 3 hours later

Thanks for writing again.

You need to get the opinion from Neurologist for this and not the Psychiatrist. Neurological examination with MRI findings is must.

Hope, this answers your query. Wish you and your mother a good health.

Above answer was peer-reviewed by
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