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What do my MRI test results indicate?

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Posted on Fri, 13 May 2016
Question: What is your interpretation of this from a non contrast MRI?

Moderate diffuse cerebral and cerebellar volume loss. The ventricles are
modera
tely enlarged, however the cerebral sulci are also enlarged. There
is mild crowding of the cerebral sulci over the convexities
doctor
Answered by Dr. Erion Spaho (47 minutes later)
Brief Answer:
Dementia more probable than NPH.

Detailed Answer:
Hello and thanks for using HCM.

I have read your question and understand your concerns.

A small degree of brain volume loss found on MRI is normal as we age.

Significant volume loss of cerebral and cerebellar mass with enlarged ventricles is a common finding in dementias (Alzheimer's for example), rather than normal pressure hydrocephalus.

Since there are only cognitive function changes too, dementia is the most probable diagnosis.

Confirmation of NPH diagnosis requires significant improvement in cognitive function after removing cerebrospinal fluid through lumbar puncture, besides the characteristic symptoms of walking difficulties, urinary incontinence and cognitive changes.

Mental state examination also is needed to support the dementias diagnosis.

Hope you found the answer helpful.

Let me know if I can assist you further.

Greetings.
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Erion Spaho (1 hour later)
Cognitive testing was done. As per the doctor, there was cognitive deficit in the area of learning new things and retaining information
MRA of the head and neck were normal. The MRI also showed shrinking of the hypo-campus on the right and temporal lobe on the left.
doctor
Answered by Dr. Erion Spaho (43 minutes later)
Brief Answer:
Temporal shrinking a sign of dementia.

Detailed Answer:
Welcome back and thanks for being on follow up.

Temporal and hippocampal shrinking is more related to dementia, than NPH.

Since MRA was normal, vascular dementia is excluded as a possibility, Alzheimer's should be considered further since there is only cognitive impairment.

Hope this helps.

Regards.
Above answer was peer-reviewed by : Dr. Arnab Banerjee
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Answered by
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Dr. Erion Spaho

Neurologist, Surgical

Practicing since :2004

Answered : 4327 Questions

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What do my MRI test results indicate?

Brief Answer: Dementia more probable than NPH. Detailed Answer: Hello and thanks for using HCM. I have read your question and understand your concerns. A small degree of brain volume loss found on MRI is normal as we age. Significant volume loss of cerebral and cerebellar mass with enlarged ventricles is a common finding in dementias (Alzheimer's for example), rather than normal pressure hydrocephalus. Since there are only cognitive function changes too, dementia is the most probable diagnosis. Confirmation of NPH diagnosis requires significant improvement in cognitive function after removing cerebrospinal fluid through lumbar puncture, besides the characteristic symptoms of walking difficulties, urinary incontinence and cognitive changes. Mental state examination also is needed to support the dementias diagnosis. Hope you found the answer helpful. Let me know if I can assist you further. Greetings.