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What Do These MRI Findings Indicate?
Question: Hi, i have been having alot of complications with my head for the past two years especially recently i cannot drive for more than 25 minutes i get dizzzy and that sucks because i love driving i have constant irritated feeling on the left side of my head very bad headaches numbness loss of balance at times and heavy feeling and sometimes feels itchy inside my head i have had an mri recently and my doctor did not explain i will post it please help its been two whole years and that i had to push my doctor to do an mri he said there is nothing there but according to mri there is besides the head problems i also have palpitations digestive problems and weakness and swollen throat please help!
The mri results are as follows
No evidence of accute hemishperic infract,mass, mass effect or gross hemorrage, There is localized cystic encephalomalacia adjacent to the body of the right lateral ventricle involving the posterior aspect of the right caudate nucleus. Imaging appearance is groslly unchanged in comparison to that of the CT scan ( of which was clean). There is adjacent increased T2/Flair Signal posterior to this suggestion gliosis. Mild ex vacuo dilation of the right ventricle.
The mri results are as follows
No evidence of accute hemishperic infract,mass, mass effect or gross hemorrage, There is localized cystic encephalomalacia adjacent to the body of the right lateral ventricle involving the posterior aspect of the right caudate nucleus. Imaging appearance is groslly unchanged in comparison to that of the CT scan ( of which was clean). There is adjacent increased T2/Flair Signal posterior to this suggestion gliosis. Mild ex vacuo dilation of the right ventricle.
Brief Answer:
MRI suggests something occurred some time ago
Detailed Answer:
Good day. I've read your symptoms and the MRI report's results. The report states that a small area of your brain on the right side located next to a structure called the LATERAL VENTRICLE and involving the CAUDATE NUCLEUS (area mostly for motor relay connections to other parts of the brain and spinal cord) has been damaged. The appearance on the scan is that of an event which would've occurred months to years ago.
Unfortunately, the scan cannot tell us exactly what happened. But the symptoms you have of dizziness, headaches, and just not feeling well in general are totally understandable given the circumstance. This sort of picture radiographically is usually seen when patients have suffered a stroke, infection of the brain, traumatic head injury, or a bleed.
Can you think back from about let's say 4-6 months ago up to say 1-2 years ago and say whether or not it's possible that ANY OF THOSE things could've involved your head or brain? Were you particularly ill with what you thought may have a very bad cold or flu...maybe with a very high fever? Or were you involved in a car accident where you hit your head or other accident where you may have knocked out for a few seconds or even few minutes?
Do you really having an exceptionally bad headache as you've never had in your life which may have even caused you to get nauseous, vomit, and then, nearly pass out...or even pass out. Maybe you just slept it off for a day or 2 and then, went about your business. Maybe you were really dizzy and off balance for a few days or few weeks and then, slowly got better?
I suppose you'd know if you'd had a stroke with one side of the body being much weaker or even numb compared to the other. But then, the conundrum sets in as to what if you don't recall any of those things?
What you could really use is a solid neurological evaluation by an expert who can look for subtle deficits since you're young and could be easily adaptable to these sorts of traumas much better than older people who suffer strokes and who are then, paralyzed or unable to speak.... Is there any family history of strokes or other medical conditions? Does anybody have a blood clotting disorder in your family, Lupus, or a history of forming blood clots in the veins, etc.? Anybody in your family suffer strokes at a young age, etc.? Anybody with unexplained headaches or balance problems such as you?
These are just some of the questions you could be asked by the right specialist.
Therefore, I recommend a visit to a neurologist who will definitely know how to go about the workup of this sort of picture and figure out first what caused this to happen. Then, the task of figuring out how to prevent another event will be undertaken followed by the actual treatment of your troublesome symptoms of the headaches, dizziness, etc.
I hope this addresses your concerns and that you will keep me in mind for future queries and questions regarding these or other neurological/medical issues that I may be able to help resolve.
I would appreciate your rating of this interaction on a HIGH STAR SCALE if you find it helpful or informative related to your condition and would very much appreciate a few words related to feedback that you'd like to express in whatever light you wish to express yourself.
Write to me at: bit.ly/drdariushsaghafi for additional comments, concerns, or to provide status updates if this is possible.
This consult request has taken a total of 17 minutes of time to read, research, and envoy as a response to the patient.
MRI suggests something occurred some time ago
Detailed Answer:
Good day. I've read your symptoms and the MRI report's results. The report states that a small area of your brain on the right side located next to a structure called the LATERAL VENTRICLE and involving the CAUDATE NUCLEUS (area mostly for motor relay connections to other parts of the brain and spinal cord) has been damaged. The appearance on the scan is that of an event which would've occurred months to years ago.
Unfortunately, the scan cannot tell us exactly what happened. But the symptoms you have of dizziness, headaches, and just not feeling well in general are totally understandable given the circumstance. This sort of picture radiographically is usually seen when patients have suffered a stroke, infection of the brain, traumatic head injury, or a bleed.
Can you think back from about let's say 4-6 months ago up to say 1-2 years ago and say whether or not it's possible that ANY OF THOSE things could've involved your head or brain? Were you particularly ill with what you thought may have a very bad cold or flu...maybe with a very high fever? Or were you involved in a car accident where you hit your head or other accident where you may have knocked out for a few seconds or even few minutes?
Do you really having an exceptionally bad headache as you've never had in your life which may have even caused you to get nauseous, vomit, and then, nearly pass out...or even pass out. Maybe you just slept it off for a day or 2 and then, went about your business. Maybe you were really dizzy and off balance for a few days or few weeks and then, slowly got better?
I suppose you'd know if you'd had a stroke with one side of the body being much weaker or even numb compared to the other. But then, the conundrum sets in as to what if you don't recall any of those things?
What you could really use is a solid neurological evaluation by an expert who can look for subtle deficits since you're young and could be easily adaptable to these sorts of traumas much better than older people who suffer strokes and who are then, paralyzed or unable to speak.... Is there any family history of strokes or other medical conditions? Does anybody have a blood clotting disorder in your family, Lupus, or a history of forming blood clots in the veins, etc.? Anybody in your family suffer strokes at a young age, etc.? Anybody with unexplained headaches or balance problems such as you?
These are just some of the questions you could be asked by the right specialist.
Therefore, I recommend a visit to a neurologist who will definitely know how to go about the workup of this sort of picture and figure out first what caused this to happen. Then, the task of figuring out how to prevent another event will be undertaken followed by the actual treatment of your troublesome symptoms of the headaches, dizziness, etc.
I hope this addresses your concerns and that you will keep me in mind for future queries and questions regarding these or other neurological/medical issues that I may be able to help resolve.
I would appreciate your rating of this interaction on a HIGH STAR SCALE if you find it helpful or informative related to your condition and would very much appreciate a few words related to feedback that you'd like to express in whatever light you wish to express yourself.
Write to me at: bit.ly/drdariushsaghafi for additional comments, concerns, or to provide status updates if this is possible.
This consult request has taken a total of 17 minutes of time to read, research, and envoy as a response to the patient.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi,
Thank you for you're answer now i finally have an idea of what is going on. To answer some of ur questions no one has any history of such problems strokes un usual headaches etc.. I havent been in an accident or head injuries or any bad fevers. This whole time every doctor would tell me my symptoms are from anxiety im not an anxious person you could say i developed somewhat of an anxiety after being told so much that i have anxiety but other than that im a very strong person but i also worry way too much no according to what you explained from youre understanding this damage is it something thats curable? is there hope for me will i ever be normal again and be able to drive and live a happy life with out these comlications because waking up with a constant headache every single day is hard and not being able to drive anymore sucks even more so is this condition treable with drugs or surgery?
Thank you for you're answer now i finally have an idea of what is going on. To answer some of ur questions no one has any history of such problems strokes un usual headaches etc.. I havent been in an accident or head injuries or any bad fevers. This whole time every doctor would tell me my symptoms are from anxiety im not an anxious person you could say i developed somewhat of an anxiety after being told so much that i have anxiety but other than that im a very strong person but i also worry way too much no according to what you explained from youre understanding this damage is it something thats curable? is there hope for me will i ever be normal again and be able to drive and live a happy life with out these comlications because waking up with a constant headache every single day is hard and not being able to drive anymore sucks even more so is this condition treable with drugs or surgery?
Brief Answer:
Encephalomalacia- brain atrophy/degeneration- possibly stroke
Detailed Answer:
Thank you for the clarifying information. Well, if you are unaware of any injury (even as an infant? Could you have fallen accidentally?) then, I don't know that we can know for sure how that area of encephalomalacia came to be, however, you will not be able to "replace" or replenish that portion which is deteriorated. But I believe you can get back to normal quite easily AND still study what happened in a bit more depth so as to prevent the same thing from happening to the other side. If we take traumatic injury out of the picture then, the most common cause of what happened to you probably was as the result of a vascular injury meaning you had a stroke (even though you're not aware of any such event). Therefore, you should have what we would refer to as a vascular stroke workup performed and have your doctors look at your right internal carotid artery, your heart, and other major blood vessels that feed the brain and that part of the brain looking for obstructions, malformations, or other pathology that could've resulted in the formation of a blood clot. For instance, in the heart you should have an echocardiogram done as well as a Holter monitor for at least 15-30 days to see if there are any arrhythmias that could've resulted in the throwing of a clot up to that part of the brain. Again, I agree that having a stroke of that magnitude and not know anything about it is remarkable.....but it can happen and I will tell you in what scenario I'm thinking...it just may tie in to your other complaints that you feel your doctors have been blowing off for a long time.
From a study that I researched there are definitely patients who can suffer strokes of the right caudate nucleus who show ONLY neuropsychological symptoms and do not have any motor, sensory, or significant cognitive deficits....so it is POSSIBLE to have a stroke and not really know it...perhaps, other people might notice it...but then, again if they are people you know at work or wherever maybe they're just too polite to say anything about how you might've changed.
And so, in your case there are known patients who have stroked out a very small area of the RIGHT CAUDATE NUCLEUS in an area known as the lenticulostriate region. If the ANTERIOR portion of the complex is affected only then, neuropsychological behavioral changes can be seen of usually only a mild nature. If the LATERAL portion of the region is affected then, MORE PROMINENT NEUROPSYCHOLOGICAL ISSUES may be noted.
The neuropsychological symptoms that are most noticed in strokes of the caudate nucleus have been found to be conditions of depression, abulia (an absence of willpower or an inability to act decisively, as a symptom of mental illness.), restlessness, confusional states (most commonly upon awakening).
You may benefit therefore, and based upon your MRI findings from a NEUROPSYCHOLOGICAL battery of tests.....NOT psychological testing....and NOT psychiatric testing...but NEUROPYSCHOLOGICAL testing. I would limit the amount of information that the neuropsychologist knows regarding your condition at the outset. You may tell them for instance that you received an MRI of the brain and have been suffering with anxiety for many years. See what the test shows and if the neuropsychologist actually FINDS abnormalities in your tests which can be localized to the RIGHT CAUDATE NUCLEUS. After the tester reads your results then, you can disclose the exact findings of the MRI study and the neuropsychologist can then, decide whether there may be additional tests to do in order to study that particular area of the brain....depending upon what they assessed on you in the first place.
Make sense?
Can you upload the actual MRI IMAGE OF THE BRAIN that shows this right sided caudate nucleus atrophy?
Now, once you've been tested thoroughly then, a plan can be worked on in order to help you rehabilitate that part of the brain that has been damaged. The neuropsychologist will be able to tell you what sorts of cognitive or brain exercises you need to do.
I hope this addresses your concerns and that you will keep me in mind for future queries and questions regarding these or other neurological/medical issues that I may be able to help resolve.
I would appreciate your rating of this interaction on a HIGH STAR SCALE if you find it helpful or informative related to your condition and would very much appreciate a few words related to feedback that you'd like to express in whatever light you wish to express yourself.
Write to me at: bit.ly/drdariushsaghafi for additional comments, concerns, or to provide status updates if this is possible.
This consult request has taken a total of 77 minutes of time to read, research, and envoy as a response to the patient.
Encephalomalacia- brain atrophy/degeneration- possibly stroke
Detailed Answer:
Thank you for the clarifying information. Well, if you are unaware of any injury (even as an infant? Could you have fallen accidentally?) then, I don't know that we can know for sure how that area of encephalomalacia came to be, however, you will not be able to "replace" or replenish that portion which is deteriorated. But I believe you can get back to normal quite easily AND still study what happened in a bit more depth so as to prevent the same thing from happening to the other side. If we take traumatic injury out of the picture then, the most common cause of what happened to you probably was as the result of a vascular injury meaning you had a stroke (even though you're not aware of any such event). Therefore, you should have what we would refer to as a vascular stroke workup performed and have your doctors look at your right internal carotid artery, your heart, and other major blood vessels that feed the brain and that part of the brain looking for obstructions, malformations, or other pathology that could've resulted in the formation of a blood clot. For instance, in the heart you should have an echocardiogram done as well as a Holter monitor for at least 15-30 days to see if there are any arrhythmias that could've resulted in the throwing of a clot up to that part of the brain. Again, I agree that having a stroke of that magnitude and not know anything about it is remarkable.....but it can happen and I will tell you in what scenario I'm thinking...it just may tie in to your other complaints that you feel your doctors have been blowing off for a long time.
From a study that I researched there are definitely patients who can suffer strokes of the right caudate nucleus who show ONLY neuropsychological symptoms and do not have any motor, sensory, or significant cognitive deficits....so it is POSSIBLE to have a stroke and not really know it...perhaps, other people might notice it...but then, again if they are people you know at work or wherever maybe they're just too polite to say anything about how you might've changed.
And so, in your case there are known patients who have stroked out a very small area of the RIGHT CAUDATE NUCLEUS in an area known as the lenticulostriate region. If the ANTERIOR portion of the complex is affected only then, neuropsychological behavioral changes can be seen of usually only a mild nature. If the LATERAL portion of the region is affected then, MORE PROMINENT NEUROPSYCHOLOGICAL ISSUES may be noted.
The neuropsychological symptoms that are most noticed in strokes of the caudate nucleus have been found to be conditions of depression, abulia (an absence of willpower or an inability to act decisively, as a symptom of mental illness.), restlessness, confusional states (most commonly upon awakening).
You may benefit therefore, and based upon your MRI findings from a NEUROPSYCHOLOGICAL battery of tests.....NOT psychological testing....and NOT psychiatric testing...but NEUROPYSCHOLOGICAL testing. I would limit the amount of information that the neuropsychologist knows regarding your condition at the outset. You may tell them for instance that you received an MRI of the brain and have been suffering with anxiety for many years. See what the test shows and if the neuropsychologist actually FINDS abnormalities in your tests which can be localized to the RIGHT CAUDATE NUCLEUS. After the tester reads your results then, you can disclose the exact findings of the MRI study and the neuropsychologist can then, decide whether there may be additional tests to do in order to study that particular area of the brain....depending upon what they assessed on you in the first place.
Make sense?
Can you upload the actual MRI IMAGE OF THE BRAIN that shows this right sided caudate nucleus atrophy?
Now, once you've been tested thoroughly then, a plan can be worked on in order to help you rehabilitate that part of the brain that has been damaged. The neuropsychologist will be able to tell you what sorts of cognitive or brain exercises you need to do.
I hope this addresses your concerns and that you will keep me in mind for future queries and questions regarding these or other neurological/medical issues that I may be able to help resolve.
I would appreciate your rating of this interaction on a HIGH STAR SCALE if you find it helpful or informative related to your condition and would very much appreciate a few words related to feedback that you'd like to express in whatever light you wish to express yourself.
Write to me at: bit.ly/drdariushsaghafi for additional comments, concerns, or to provide status updates if this is possible.
This consult request has taken a total of 77 minutes of time to read, research, and envoy as a response to the patient.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you very much for giving me an idea so it is treatable easily and i can go back to normal? i can drive and enjoy regular activities?
Brief Answer:
With proper further evaluation I believe you will be fine
Detailed Answer:
I believe the discovery of your caudate nucleus defect is an unexpected find and very well may be able to explain your symptoms. Therefore, there is a good chance that with further evaluation and follow up things can be definitely improved However, I emphasize what I wrote in the previous note. There still needs to be a good history taken with respect to when and under what circumstance your complaints became known to either yourself or others. That information then, needs to be brought into focus with additional testing results in order to determine any cause/effect relationship.
If you were being treated in my clinic or office I would be arranging for neuropsychological testing. Once there was confirmation that one is related to the other then, the work of rehabilitation becomes a matter of putting in the time and effort in conjunction with the guidance of an expert who knows how to deal with your symptoms as a sequelae of some type of brain "injury" (though we still may not know its origin).
As far as the headaches are concerned well, that may or may not be directly related to your symptoms as well as the caudate nucleus defect. If you would like to open a separate query regarding the headaches I would be happy to address that problem. In my practice with headache patients we approach things from a very commonsense yet underused platform of DOCUMENTING CHARACTERISTICS of the headache (headache log) in order to know exactly what type may be bothering you and how best to deal with them.
I hope this addresses your concerns and that you will keep me in mind for future queries and questions regarding these or other neurological/medical issues.
I'd appreciate your HIGH STAR rating if you have found the information helpful and would much appreciate a few words of feedback you'd like to express.
Write to me at: bit.ly/drdariushsaghafi for additional comments, concerns, or to provide status updates which I'd be interested in knowing.
This consult request has taken a total of 97 minutes of time to read, research, and envoy as a response to the patient.
With proper further evaluation I believe you will be fine
Detailed Answer:
I believe the discovery of your caudate nucleus defect is an unexpected find and very well may be able to explain your symptoms. Therefore, there is a good chance that with further evaluation and follow up things can be definitely improved However, I emphasize what I wrote in the previous note. There still needs to be a good history taken with respect to when and under what circumstance your complaints became known to either yourself or others. That information then, needs to be brought into focus with additional testing results in order to determine any cause/effect relationship.
If you were being treated in my clinic or office I would be arranging for neuropsychological testing. Once there was confirmation that one is related to the other then, the work of rehabilitation becomes a matter of putting in the time and effort in conjunction with the guidance of an expert who knows how to deal with your symptoms as a sequelae of some type of brain "injury" (though we still may not know its origin).
As far as the headaches are concerned well, that may or may not be directly related to your symptoms as well as the caudate nucleus defect. If you would like to open a separate query regarding the headaches I would be happy to address that problem. In my practice with headache patients we approach things from a very commonsense yet underused platform of DOCUMENTING CHARACTERISTICS of the headache (headache log) in order to know exactly what type may be bothering you and how best to deal with them.
I hope this addresses your concerns and that you will keep me in mind for future queries and questions regarding these or other neurological/medical issues.
I'd appreciate your HIGH STAR rating if you have found the information helpful and would much appreciate a few words of feedback you'd like to express.
Write to me at: bit.ly/drdariushsaghafi for additional comments, concerns, or to provide status updates which I'd be interested in knowing.
This consult request has taken a total of 97 minutes of time to read, research, and envoy as a response to the patient.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi, also one thing id like to mention is very embarassing but has to be said is i cornically masterbate every day 1-3 times since i was 12 now im 22 can that be the result for balance dizzieniss and my brain damage as well as palpitations? please advise
Brief Answer:
No need to be embarrassed
Detailed Answer:
Hello and thank you for that final question in this thread.
Masturbation is a normal human function in both men and women. Frequency can vary from individual to individual. Many stories as to what the act of masturbating can do or not do abound from culture to culture.
Not sure why our race is so fascinated with taking a very routine and common bodily function and turning it into something that it's not. It cannot CAUSE any type of harm to you in any physical way and therefore, the area of brain deterioration in no way is related to that activity. Nor can masturbation cause or affect any sense of dizziness or imbalance nor palpitations.
These symptoms should be looked at by appropriate specialists and in a 22 year old who is otherwise healthy will tend to turn out to be benign causes.
I hope this addresses your concerns and that you will keep me in mind for future queries and questions regarding these or other neurological/medical issues.
I'd appreciate your HIGH STAR rating if you have found the information helpful and would appreciate a few words of feedback if you'd take just a few moments to write them.
Please feel free to open a NEW QUERY by writing to me at: bit.ly/drdariushsaghafi with additional questions, concerns, or to provide status updates which I'd be interested in knowing. At the same time please take a moment and CLOSE the current question so answers can be archived and available for others who may benefit.
This consult request has taken a total of 105 minutes of time to read, research, and envoy as a response to the patient.
No need to be embarrassed
Detailed Answer:
Hello and thank you for that final question in this thread.
Masturbation is a normal human function in both men and women. Frequency can vary from individual to individual. Many stories as to what the act of masturbating can do or not do abound from culture to culture.
Not sure why our race is so fascinated with taking a very routine and common bodily function and turning it into something that it's not. It cannot CAUSE any type of harm to you in any physical way and therefore, the area of brain deterioration in no way is related to that activity. Nor can masturbation cause or affect any sense of dizziness or imbalance nor palpitations.
These symptoms should be looked at by appropriate specialists and in a 22 year old who is otherwise healthy will tend to turn out to be benign causes.
I hope this addresses your concerns and that you will keep me in mind for future queries and questions regarding these or other neurological/medical issues.
I'd appreciate your HIGH STAR rating if you have found the information helpful and would appreciate a few words of feedback if you'd take just a few moments to write them.
Please feel free to open a NEW QUERY by writing to me at: bit.ly/drdariushsaghafi with additional questions, concerns, or to provide status updates which I'd be interested in knowing. At the same time please take a moment and CLOSE the current question so answers can be archived and available for others who may benefit.
This consult request has taken a total of 105 minutes of time to read, research, and envoy as a response to the patient.
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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