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What Do These MRI Findings Indicate?

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Posted on Fri, 7 Jul 2017
Question: Hi doctor,

Yesterday my mom took her regular medicine ( tricinod, dompan, lapicure 20, clopitab for morning) after food and slept she woke up after an hour with lot of sweat (in ac room) , shortness of breath, pain in left shoulder which starts from neck to fingers, also her hand fingers got stiff and turned, her leg fingers was num... and shivering. I immediately called up our family doctor he visited and checked her BP it was 150/80.. he thought it's a Stoke and suggested us to shift her to ICU...

In hospital they checked her BP 180/90.... They gave stampl 5mg , and took ECG which was normal, later after 1-2 hours they took 2d echo which was also normal, again after an hour they took another ECG and it was came out normal around 3am they checked her BP it was around 160/80 so depending on diagnostic doctor told us that all symptoms does not indicate heart Stoke,
rather a thought it might be small paralysis stoke and advise us to go for MRI stoke protocol.
(She has osteoporosis, R arthritis)

Recently she was also diagnosed with renal parachymal disease grade 1 for kidney.
Her urea is 5.1, BUN 30, serium creatine 1.51
For this she is taking B long F, Loy D3, sebuxo, methycobal

She also has multiple gall bladder stones largest measuring 11 mm
Also from past 2-3 months she complained about heart pain in left side along with left arm pain.
Generally her minimum BP is always 150 /80,90 and even shoots up till 210-220 but this is first time she had such condition.

I have attached yesterday ICU report and today's MRi report.

Request you to translate MRi into simple understanable English.
And I want to know, can we correlate MRI observations with yesterday's situation
Just after an hour of taking tablets why she developed such conditions.
(She has been taking it from past 2months)

Can we expect such incidents to repeat in future as well.




doctor
Answered by Dr. Bhanu Partap (1 hour later)
Brief Answer:
Her reports are normal as per her age

Detailed Answer:
Hello Mr Mir

Sorry to hear that your mother went through such an event, I completely understand your concern for her.

I have gone through the reports and initial evaluation sheet attached by you and here I will try to answer the questions.

1. MRI report Is basically suggestive of age related degeneration that happen in all the organs including brain. There is no evidence of infarct which means that there is no dead tissue or injured tissue in brain. Which ultimately means no stroke. Although there are some mild narrowing in the blood vessels of the brain which could have caused her that limb twisting and numbness in fingers during her high blood pressure.

Taking this into consideration it's advisable that you should get one opinion of a good NEUROPHYSICIAN.

2. Her blood pressure needs regular monitoring and if it's persisting more than 150/90 mmhg then her blood pressure medicine needs to be adjusted.

3. Although it's not certain but the possibility of having such an event in future can't be denied. She need good blood pressure control.

I hope this information will answer your questions. Feel free to ask if you have any more doubts.

Kind regards
Dr Bhanu partap
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Bhanu Partap (29 hours later)
Hi doctor,

Today took her to neuro physician and he suggested Video EEG

EEG was normal and he prescribe these medicines

Vertin 24 Morning
Vertin 48 Night
Dizitac Night
Dolo 600 M-N
Rantac 300 Morning
Dicorate ER 200 M-N
Imdur 30 Morning
Lipvas 20 Night

along with these he suggested to continue followed tablets prescribed earlier by cardiologist

Tricinod M-N
Clopitab Afternoon
Esosprin 75 Morning
Nikoran-5 M-N

whereas after MRI resident neuro physician also informed to continue above 4 tablets but also added Clinaxon 500 to be taken anytime

so in total she has to take 13 tablets

more over for kidney renal parachymal disease grade 1 she was suggested these tables

Methycobal 500mg Afternoon
LoYD3 once a week anytime
B long F Afternoon
Sebuxo Alternate day in Night
which she has stopped from a week

(Currently her Uric acid 5.1, BUN 30, Serum creatinine 1.51, Serum Sodium 141 mmol/l, Serum calcium 9 mg/dl)

Here i want to know if mild narrowing of blood vessels in her right PCA can be treated in time

Can we treat and bring back these blood vessels back to normal , if yes what is the time frame we are looking at or because of age degeneration she needs to just continue taking tablets to keep the blood flowing smoothly.

And i see tablets Dolo 600 and escosprin 75 perform similar action, so can we take it alternatively instead.

Also Is it normal for her to have these many tablets in ONE day

Just an fyi, for kidney disease she waa taking Ayurveda medicine Mutrakrichantak churna and V1 tablets for arthritis along with two other unani medicine for kidney disease which she has also stopped from a week

And finally just to reiterate she has,

Cardic issues
Gall glabber issue
Kidney issue
Oesteoprosis
Arthritis
and this mild narrowing of blood vessels as found in MRI
doctor
Answered by Dr. Bhanu Partap (9 hours later)
Brief Answer:
Hello Mir

Detailed Answer:
Age related degeneration cannot be reverted back to normal, thats beyond the expertise of medical science as of now.

The changes which are there in the blood vessel are mild for now so it's not advisable to treat them with some kind of interventional procedure taking into consideration the risk benefit ratio.

So as of now the progress of this age related degeneration can just be slowed down with the help of medicines.

No DOLO and ECOSPRIN are two different drugs and they can't substitute each other.

I understand your concern for her on being such a long list of medicines but there is no other way out.

Just try to keep her stress free and happy. It's a proven medical fact that patients who stay happy fight with their diseases much better than others do.

May God Bless her with good health and long life.

Kind Regards
Dr Bhanu partap
Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Yogesh D
doctor
Answered by
Dr.
Dr. Bhanu Partap

Cardiologist

Practicing since :2010

Answered : 4758 Questions

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What Do These MRI Findings Indicate?

Brief Answer: Her reports are normal as per her age Detailed Answer: Hello Mr Mir Sorry to hear that your mother went through such an event, I completely understand your concern for her. I have gone through the reports and initial evaluation sheet attached by you and here I will try to answer the questions. 1. MRI report Is basically suggestive of age related degeneration that happen in all the organs including brain. There is no evidence of infarct which means that there is no dead tissue or injured tissue in brain. Which ultimately means no stroke. Although there are some mild narrowing in the blood vessels of the brain which could have caused her that limb twisting and numbness in fingers during her high blood pressure. Taking this into consideration it's advisable that you should get one opinion of a good NEUROPHYSICIAN. 2. Her blood pressure needs regular monitoring and if it's persisting more than 150/90 mmhg then her blood pressure medicine needs to be adjusted. 3. Although it's not certain but the possibility of having such an event in future can't be denied. She need good blood pressure control. I hope this information will answer your questions. Feel free to ask if you have any more doubts. Kind regards Dr Bhanu partap