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What Does "Mild Diffuse Involutiona Cerebral Volume Loss" In An MRI Report Suggest?

Posted on Tue, 19 Aug 2014

Question: Hello Dr.

I'm 28 years old female. and I have done MRI tests for the matter of tinnitus. But the MRI results found the following
"Mild diffuse involutiona cerebral volume loss with prominence of the extra-axial CSF spaces overlying the frontal convexities.
There is no restricted diffusion to suggest recent ischemic process. No definite intracranial hemorrhage on susceptibility weighted images. There is not intra or extra-axial mass or vasogenic edema. Ventricular system is normal in size and configuration. Major vascular flow voids are unremarkable. There is no extra-axial fluid collection.
There is no enhancing lesion in the IAC or CP angle bilaterally. The membranous labyrinth structures are unremarkable.
There is no abnormal meningeal or parenchymal enhancement.
Bilateral orbits and mastoids are unremarkable. The visualized paranasal sinuses are clear."

I'm very worried that I have cerebral volume loss as I'm only 28 years old.
will I have problems in the future ? can I live normal life and have kids ?

will I loss more volume from my brain and if yes what is the expected age in my case ?

Thanks,
XXXX

Answered by Dr. Sudhir (22 minutes later)

Brief Answer:
Please post few MRI images here.

Detailed Answer:
I will review your MRI images and let you know - if at all there is volume loss and if it is there, is it significant to be worried.

Also let me know few things- are you alcoholic? Was there any uneventful incidence at birth, did you cry immediately after birth, or needed long stay in neonatal ICU? Do suffer from any metabolic disease? any hereditary disease that runs in family? Are on any medications? Any reaction to vaccines or brain infection in past?

Awaiting your reply.Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sudhir (8 minutes later)

Hi Dr.
I have the full file of MRI images. not sure what do you like to see. please see the two screenshot and let me know what to send for you.

I'm not alcoholic at all. I don;t think I got any incedint when I was born. But I got very huge hit by swimming pool in the back side of my head when I was 11 years old. I'm not sure if I cryed when I was born, I can't answer the question.
I did not stay at ICU. I don't have any disease.
But since 6 month I'm suffering from Tinnitus in both ears.

Thanks

Answered by Dr. Sudhir (46 minutes later)

Brief Answer:
Send images where you ear pinna is seen

Detailed Answer:
Send images where you external ear pinna is seen, this will give me some mid sections of your brain. Add 5-6 images .Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sudhir (4 minutes later)

please have a look to what I uploaded.
If it is not sufficient, let me know.

Thanks

Answered by Dr. Sudhir (49 minutes later)

Brief Answer:
Add few more upper sections

Detailed Answer:
Add few more upper sections.Also add images of some other sequence- may be one with more white color.May it has been labelled as T2 images.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sudhir (16 minutes later)

I uploaded another one called t2_trs_tra

if it is not the one please let me know

Answered by Dr. Sudhir (12 minutes later)

Brief Answer:
Will go through images and let you know

Detailed Answer:
Give some time.Hope thats fine.May be after few hours I will post a answer.Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sudhir (23 hours later)

Hi Dr.
Did you get the chance to review my MRI images ?

Thanks,

Answered by Dr. Sudhir (17 minutes later)

Brief Answer:
Saw the images.

Detailed Answer:
First of all this is nothing to be concerned about.

Actually this is not a volume loss but just the sulcal spaces are prominent in your case.

If there is generalised neural volume loss there would be dilatation of ventricular system and cisterns.But both are fine your case.
Such prominent sulci can be seen in cases of old head injury due subdural hygromas.Subdural hygroma are just prominent normal brain fluid/csf filled spaces which dont need treatment.

So this is not a volume loss.

Just for your information- Had it been volume loss, still there is nothing one can do about it,if there is no underlying cause.

In my experience if there is volume loss to milder extent, those individuals are normal as others.

So no need to worry.Regards

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Sudhir (22 minutes later)

Thanks a lot

so this means that I have normal brain as people in my age ? so do you suggest that I was born like this ?
also I asked my mother, she said I did not cry when I was born but I did not enter any emergency unit.

Will I face any problem in the future about this case ?

Answered by Dr. Sudhir (29 minutes later)

Brief Answer:
No tests needed.

Detailed Answer:
You wont have any problem in future.I didn't see any need to test further.

Loss of neural tissue is kind of subjective assessment made of doctor reading MRI, its not diagnositic.So dont worry about this.

I had asked about crying after birth, before seeings images.No changes related to that seen your brain.

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Sudhir (3 minutes later)

Thanks a lot for the answer..
I'm very comfortable now.

all the best

Answered by Dr. Sudhir (20 minutes later)

Brief Answer:
You are welcome

Detailed Answer:
It was pleasure assisting you.Do take out time to leave a star5 feedback, as per your wish.Regards.

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Sudhir (41 hours later)

Hi Dr.

Does My MRI results shows that I have subdural hygromas ?
I was reading on the internet about subdural hygromas and it causes serious consequences ended with death.

Thanks

Answered by Dr. Sudhir (2 hours later)

Brief Answer:
There are no subdural hygromas.

Detailed Answer:
There is no evidence of subdural hygromas.

Anyways most subdural hygromas are asymptomatic and dont lead to complications.

Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sudhir (4 minutes later)

Thanks for the answer.

Also I would like to ask if my MRI images show Arteries and veins and how the blood flow through them ?

Thanks

Answered by Dr. Sudhir (13 minutes later)

Brief Answer:
Actually this images are not entirely for arteries

Detailed Answer:
One has to get MRI angiography done for arteries.However in these images arteries seem fine.Had there been problem with arteries, it would have reflected in brain images.

Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar