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Dr. Andrew Rynne

Family Physician

Exp 50 years

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What can you interpret from an MRI report of a patient suffering from migraines with aura and dizziness?

Answered by
Dr. Suresh Heijebu

General & Family Physician

Practicing since :2010

Answered : 3579 Questions

Posted on Wed, 22 Aug 2018 in Headache and Migraines
Question: I am a 77 yo male with a recent MRI because of migraines w/aura and dizziness. The MRI shows moderate cortical atrophy. No acute hemorrhage, midline shift or hydrocephalus. No intra-axial or extra-axial fluid collection. Diffusion-weighted images are negative for an acute infarct. On the FLAIR sequences, there is multifocal signal abnormality in the periventricular white matter consistent with moderate chronic small-vessel changes.
The orbits, retrobulbar spaces, sella, brainstem and internal auditory canals are normal in signal. Mild mucosa thickening in the right maxillary sinus. Remaining sinuses are clear.
1. Atrophy with moderate chronic small-vessel ischemic changes.
2.Negative for acute infarct.
3. Minimal right maxillary sinus disease.
I will see my FP for a follow-up next week, what can I expect? Should I be concerned? What questions should I ask of her?
Answered by Dr. Suresh Heijebu 2 hours later
Brief Answer:
Nothing much to worry.

Detailed Answer:


I have worked through your attached query and reports in detail.

There is no significant or immediate health threat as detected on your MRI.

Long-term vascular changes are present which are quite expected in elderly people.

It's advisable to maintain blood pressure and sugar levels under adequate control.

As of now nothing to worry.

Post your further queries if any.

Thank you.
Above answer was peer-reviewed by : Dr. Kampana
Follow up: Dr. Suresh Heijebu 4 days later
Thanks for the answer Doc. I’m obviously pleased with the answer you provided. However, I would like to know about long-term implications. Will this condition worsen over time? Is there something I can do that will lessen the advance? I understand the importance of maintaining a healthy lifestyle, but is that all I can do?

Answered by Dr. Suresh Heijebu 9 hours later
Brief Answer:
Both are very gradual ongoing processes.

Detailed Answer:

Hello Sir,

I can certainly understand your concern.

I have worked through your attached query in detail.

The vascular changes are known to slowly worsen over a time period. Maintenance of blood pressure and blood sugar levels within normal limits will help to delay this damage over a time period.

Cortical atrophy on the other hand is more an ongoing process.

Having said that, these processes are extremely slow.

Hence this should not be a significant concern.

Take care.

Dr. Suresh Heijebu, General & Family Physician
Above answer was peer-reviewed by : Dr. Prasad

The User accepted the expert's answer

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