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What does MRI report showing chronic gliosis indicate?

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Posted on Wed, 30 Jul 2014
Question: I am 27 years old and a month ago I fainted/ or had a seizure, after I woke up I had no memory of the event and could not recognize people around me. Then after having a sweet candy my memory recovered.

Now, my MRI report concludes that I have Chronic Gliosis possibly ischemic with a Slit like cavity. What does that mean? What could have caused it ?
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Answered by Dr. Sudhir Kumar (8 minutes later)
Brief Answer:
Either old ischemia or old infection.

Detailed Answer:
Hi,

Thank you for posting your query.

I have noted your symptoms and MRI brain report.

Gliosis refers to scar in the brain, as a result of old insult.

The most common causes for this gliosis are ischemia (lack of blood flow to the brain) and infection (such as tapeworm infection). In any case, this is not an active disease of brain, and hence, no specific treatment is needed.

As of now, you are on correct medicines- levetiracetam to prevent seizures in future and rosuvastatin to reduce cholesterol levels.

I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.

Wishing you good health,

Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, XXXXXXX XXXXXXX
Click on this link to ask me a DIRECT QUERY: http://bit.ly/Dr-Sudhir-kumar
My BLOG: http://bestneurodoctor.blogspot.in


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Sudhir Kumar (2 hours later)
I have uploaded an image representing the Micro-hemorrhages (MicroH.jpg) and the detailed report and opinion of the Radiologist.

Now I have a few follow up questions:

1. Would I have to continue to take the anti-seizure medicine forever or it might be be possible to discontinue latter?

2. How do the Micro-hemorrhages relate to Ischemia, if at all?

3. Can chronic high Cholesterol lead to an ischemic lesion?

4. Is the Gliosis likely to remain stable or should I continue to monitor it in the future? If yes then, at what frequency? Every year, every 3 years etc?

5. At the end of the Radiologists opinion it mentions Vasculitis, what is that?

6. I have read elsewhere that Gliosis is related to Autoimmune and degenerative issues, should I be aware or concerned?

7. Is it safe to say that this is Gliosis and nothing else that can mimic the same?
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Answered by Dr. Sudhir Kumar (53 minutes later)
Brief Answer:
My replies are below.

Detailed Answer:
Thank you for getting back. Replies to your queries are below:

1. It may be possible to stop anti-seizure medications after three years, if you remain free of seizures.

2. In some cases, small areas of bleeding occurs in ischemia, as the underlying risk factors for ischemia and micro-hemorrhage are common (such as increased cholesterol and blood pressure).

3. Yes.

4. It would remain stable and no follow up MRI is needed to monitor the gliosis.

5. Vasculitis refers to inflammation of artery leading to ischemia. It is unlikely in your case, as usually, there are multiple areas of ischemia in vasculitis, rather than single lesion.

6. Not true for gliosis in brain

7. Yes, in your case, it is gliosis due to old ischemia.

I also feel you should be on aspirin or clopidogrel (a blood thinner) to prevent ischemia of brain in future.

In addition, you should be screened for elevated levels of homocysteine, sugar and blood pressure, which are risk factors for brain ischemia.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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What does MRI report showing chronic gliosis indicate?

Brief Answer: Either old ischemia or old infection. Detailed Answer: Hi, Thank you for posting your query. I have noted your symptoms and MRI brain report. Gliosis refers to scar in the brain, as a result of old insult. The most common causes for this gliosis are ischemia (lack of blood flow to the brain) and infection (such as tapeworm infection). In any case, this is not an active disease of brain, and hence, no specific treatment is needed. As of now, you are on correct medicines- levetiracetam to prevent seizures in future and rosuvastatin to reduce cholesterol levels. I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information. Wishing you good health, Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist Apollo Hospitals, XXXXXXX XXXXXXX Click on this link to ask me a DIRECT QUERY: http://bit.ly/Dr-Sudhir-kumar My BLOG: http://bestneurodoctor.blogspot.in