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What Does My Brain MRI Scan Report Indicate?
Question: Hi,
I am really hoping that you can provide me with some much needed piece of mind.
I’m a 33 year old man who 7 months ago paid privately for a Brain MRI (w/o contrast) in order to rule out any potential Brain Aneurysms, thankfully it came back all clear. My GP refereed me via letter stating the purpose of the test. A Neuroradiologist reviewed this and fed back to my GP stating that no aneurisms were detected!
The reason I did this was that my mother had a burst aneurysm and 2 further surgically coiled aged 41, having smoked for 25 years, as did my maternal Grandfather aged 69. I previously smoked for 8 years but have now quit, so I thought it would be a good idea as a precaution.
My question(s) is:
Was a MRI Scan without contrast an accurate technique for Brain Aneurysm identification, given my situation and background? I have read that a more detailed view can be gained by using MRA. However, am I right in thinking that MRA is used to further analyse the potential defect after identified using MRI?
Also, given that I have now stopped smoking and living a healthy lifestyle, is there any need to have a follow scan in the future? I have been advised that the chances of one developing now I have made my lifestyle changes is minimal.
I suffer quite a lot with anxiety and this is affecting me, so any help you can give relating to MRI and it effectiveness with aneurism exposure would be appreciated.
Thank you in advance
I am really hoping that you can provide me with some much needed piece of mind.
I’m a 33 year old man who 7 months ago paid privately for a Brain MRI (w/o contrast) in order to rule out any potential Brain Aneurysms, thankfully it came back all clear. My GP refereed me via letter stating the purpose of the test. A Neuroradiologist reviewed this and fed back to my GP stating that no aneurisms were detected!
The reason I did this was that my mother had a burst aneurysm and 2 further surgically coiled aged 41, having smoked for 25 years, as did my maternal Grandfather aged 69. I previously smoked for 8 years but have now quit, so I thought it would be a good idea as a precaution.
My question(s) is:
Was a MRI Scan without contrast an accurate technique for Brain Aneurysm identification, given my situation and background? I have read that a more detailed view can be gained by using MRA. However, am I right in thinking that MRA is used to further analyse the potential defect after identified using MRI?
Also, given that I have now stopped smoking and living a healthy lifestyle, is there any need to have a follow scan in the future? I have been advised that the chances of one developing now I have made my lifestyle changes is minimal.
I suffer quite a lot with anxiety and this is affecting me, so any help you can give relating to MRI and it effectiveness with aneurism exposure would be appreciated.
Thank you in advance
Brief Answer:
Simple MRI is enough for screening purpose
Detailed Answer:
Dear xxxxxx,
Thanks for using Healthcaremagic.
I read your query and understand your concerns. Infact your decision to have MRI to screen aneurysm is well grounded and recommended by experts.
In regard to utility of MRI I must assure you that for detection of aneurysms simple MRI without contrast is enough/sufficient. You do not need any further investigation as contrast as well as MRA are required when there is evidence of any abnormality. In your case no abnormality is detected on MRI and no further investigation indicated at this moment.
Regarding further development of aneurysms please get assured that healthy ife style is effective prevention.It is also true that genetics plays significant role but it becomes minimal in case there is minimal environmental contribution (read healthy life style).
I hope this helps you.
If you have any further query, I would be glad to help you.
If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback.
In future if you wish to contact me directly, you can use the below mentioned link:
http://doctor.healthcaremagic.com/doctors/dr-ashok-kumar/67386
Thanks and regards
Simple MRI is enough for screening purpose
Detailed Answer:
Dear xxxxxx,
Thanks for using Healthcaremagic.
I read your query and understand your concerns. Infact your decision to have MRI to screen aneurysm is well grounded and recommended by experts.
In regard to utility of MRI I must assure you that for detection of aneurysms simple MRI without contrast is enough/sufficient. You do not need any further investigation as contrast as well as MRA are required when there is evidence of any abnormality. In your case no abnormality is detected on MRI and no further investigation indicated at this moment.
Regarding further development of aneurysms please get assured that healthy ife style is effective prevention.It is also true that genetics plays significant role but it becomes minimal in case there is minimal environmental contribution (read healthy life style).
I hope this helps you.
If you have any further query, I would be glad to help you.
If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback.
In future if you wish to contact me directly, you can use the below mentioned link:
http://doctor.healthcaremagic.com/doctors/dr-ashok-kumar/67386
Thanks and regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you Dr Kumar!
First of all, I would like to say how very pleased I am with your response, that has certainly put my mind at ease in regards to the accuracy test that I had.
I have just a few follow up questions following your reply:
1 - It is my understanding that in order to define genetic risk, it has to be more than 1 first degree relative who has had a known aneurysm, is that the case? It was only my mother who has had an aneurysm within my first degree relatives.
2 - Regarding further development of aneurysms, I have made a number of significant lifestyle changes in the last year, specifically that I have reduced my weight by 1 stone, reduced my blood pressure and most notably quit smoking after 8 years! With all of that in mind, would you advise having a precautionary repeat MRI in the future? and if so, how long exactly?
3 - One final question, and I really mean no offence by this, but have you had much experience in the field of neurology, specifically aneurysm formation and identification? I am asking purely from the perspective that I thought I marked the original question as Neurology, however I notice that your specialism is Psychiatry? I fully trust your answer but ask for my own piece of mind, as stated earlier I suffer with anxiety hence why I worry so much.
I will not hesitate in recommending your service! I look forward to the answers to my 3 questions above.
Regards,
First of all, I would like to say how very pleased I am with your response, that has certainly put my mind at ease in regards to the accuracy test that I had.
I have just a few follow up questions following your reply:
1 - It is my understanding that in order to define genetic risk, it has to be more than 1 first degree relative who has had a known aneurysm, is that the case? It was only my mother who has had an aneurysm within my first degree relatives.
2 - Regarding further development of aneurysms, I have made a number of significant lifestyle changes in the last year, specifically that I have reduced my weight by 1 stone, reduced my blood pressure and most notably quit smoking after 8 years! With all of that in mind, would you advise having a precautionary repeat MRI in the future? and if so, how long exactly?
3 - One final question, and I really mean no offence by this, but have you had much experience in the field of neurology, specifically aneurysm formation and identification? I am asking purely from the perspective that I thought I marked the original question as Neurology, however I notice that your specialism is Psychiatry? I fully trust your answer but ask for my own piece of mind, as stated earlier I suffer with anxiety hence why I worry so much.
I will not hesitate in recommending your service! I look forward to the answers to my 3 questions above.
Regards,
Brief Answer:
Yes you are right in regard to genetic risk
Detailed Answer:
Dear xxxxx,
Thanks for follow up query.
Regarding your question about genetic risk your understanding is quite clear and we need two relatives to define because incidental aneurysms are common and they do not infer any higher risk to their relatives in compare to general population. Since you do not have any other known relatives we can say the genetic risk is not too high or in other words equal to general population.
I do not think any follow up MRI is required as per the guidelines but I will recommend one at the age of 50 years. This is keeping in possibility of late development of aneurysm which is more common with low genetic risk. Although this is my personal opinion based on the fact that you had combination of risk factors in past which included doubtful genetic risk, smoking, overweight and high blood pressure.
My experience is quite wide which includes the neurology. In fact I am working in a subspeciality of psychiatry where distinction between psychiatry and neurology do not persist (geriatric psychiatry). In addition before opting psychiatry I worked as a junior registrar in department of neurology. I can assure you that provided information is as per the standard guidelines and up to date.
I hope this assists you further.
Thanks and regards
Yes you are right in regard to genetic risk
Detailed Answer:
Dear xxxxx,
Thanks for follow up query.
Regarding your question about genetic risk your understanding is quite clear and we need two relatives to define because incidental aneurysms are common and they do not infer any higher risk to their relatives in compare to general population. Since you do not have any other known relatives we can say the genetic risk is not too high or in other words equal to general population.
I do not think any follow up MRI is required as per the guidelines but I will recommend one at the age of 50 years. This is keeping in possibility of late development of aneurysm which is more common with low genetic risk. Although this is my personal opinion based on the fact that you had combination of risk factors in past which included doubtful genetic risk, smoking, overweight and high blood pressure.
My experience is quite wide which includes the neurology. In fact I am working in a subspeciality of psychiatry where distinction between psychiatry and neurology do not persist (geriatric psychiatry). In addition before opting psychiatry I worked as a junior registrar in department of neurology. I can assure you that provided information is as per the standard guidelines and up to date.
I hope this assists you further.
Thanks and regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Brief Answer:
Yes you are right in regard to genetic risk
Detailed Answer:
Dear xxxxx,
Thanks for follow up query.
Regarding your question about genetic risk your understanding is quite clear and we need two relatives to define because incidental aneurysms are common and they do not infer any higher risk to their relatives in compare to general population. Since you do not have any other known relatives we can say the genetic risk is not too high or in other words equal to general population.
I do not think any follow up MRI is required as per the guidelines but I will recommend one at the age of 50 years. This is keeping in possibility of late development of aneurysm which is more common with low genetic risk. Although this is my personal opinion based on the fact that you had combination of risk factors in past which included doubtful genetic risk, smoking, overweight and high blood pressure.
My experience is quite wide which includes the neurology. In fact I am working in a subspeciality of psychiatry where distinction between psychiatry and neurology do not persist (geriatric psychiatry). In addition before opting psychiatry I worked as a junior registrar in department of neurology. I can assure you that provided information is as per the standard guidelines and up to date.
I hope this assists you further.
Thanks and regards
=========================
Thank you again Doctor,
To confirm that I understand clearly your response to my first query, in order to define genetic risk it requires two or more first degree relatives (parent, brother, sister) to be diagnosed with aneurysms.
Therefore, the fact that my maternal grandfather had a burst aneurysm in his neck aged 70 is not relevant?
I certainly plan to take your advice regarding a re-scan at the age of 50 as a precautionary measure. In the unlikely event that an aneurysm is uncovered, are there corrective procedures available to allow this abnormality to be safely taken care of?
My apologies for the final question, your background and experience certainly reassures me! In fact, It's good to know that such expertise is at hand.
Sincere thanks again.
Regards,
Yes you are right in regard to genetic risk
Detailed Answer:
Dear xxxxx,
Thanks for follow up query.
Regarding your question about genetic risk your understanding is quite clear and we need two relatives to define because incidental aneurysms are common and they do not infer any higher risk to their relatives in compare to general population. Since you do not have any other known relatives we can say the genetic risk is not too high or in other words equal to general population.
I do not think any follow up MRI is required as per the guidelines but I will recommend one at the age of 50 years. This is keeping in possibility of late development of aneurysm which is more common with low genetic risk. Although this is my personal opinion based on the fact that you had combination of risk factors in past which included doubtful genetic risk, smoking, overweight and high blood pressure.
My experience is quite wide which includes the neurology. In fact I am working in a subspeciality of psychiatry where distinction between psychiatry and neurology do not persist (geriatric psychiatry). In addition before opting psychiatry I worked as a junior registrar in department of neurology. I can assure you that provided information is as per the standard guidelines and up to date.
I hope this assists you further.
Thanks and regards
=========================
Thank you again Doctor,
To confirm that I understand clearly your response to my first query, in order to define genetic risk it requires two or more first degree relatives (parent, brother, sister) to be diagnosed with aneurysms.
Therefore, the fact that my maternal grandfather had a burst aneurysm in his neck aged 70 is not relevant?
I certainly plan to take your advice regarding a re-scan at the age of 50 as a precautionary measure. In the unlikely event that an aneurysm is uncovered, are there corrective procedures available to allow this abnormality to be safely taken care of?
My apologies for the final question, your background and experience certainly reassures me! In fact, It's good to know that such expertise is at hand.
Sincere thanks again.
Regards,
Brief Answer:
genetic risk alone is never sufficient to cause aneurysm alone
Detailed Answer:
Dear xxxxxx,
Thanks for writing back to me.
Yes the genetic risk is not significant but it is there as we discussed in the last query. To say it significant we need the criteria of two first degree relatives having brain aneurysm before 50 years of age to be precise. Having an aneurysm at 69 years of age is more of due to aging process rather than anything related to genetic. Considering all these facts you can ensure that there is no significant genetic risk.
Regarding prevention and treatment the healthy lifestyle is key which involves healthy eating, regular exercise of at least 200 minutes per week and avoiding predisposing factor like smoking and other substance of abuse. In case it is detected the size and symptoms of it will determine what need to be done. In case the size is below 6 mm no intervention generally required. Similarly asymptomatic aneurysm do not require intervention. In case they become symptomatic or larger than coiling is generally preferred modality of treatment.
I hope this gives you more assurance which is definitely required considering the positive family history.
Thanks and regards
genetic risk alone is never sufficient to cause aneurysm alone
Detailed Answer:
Dear xxxxxx,
Thanks for writing back to me.
Yes the genetic risk is not significant but it is there as we discussed in the last query. To say it significant we need the criteria of two first degree relatives having brain aneurysm before 50 years of age to be precise. Having an aneurysm at 69 years of age is more of due to aging process rather than anything related to genetic. Considering all these facts you can ensure that there is no significant genetic risk.
Regarding prevention and treatment the healthy lifestyle is key which involves healthy eating, regular exercise of at least 200 minutes per week and avoiding predisposing factor like smoking and other substance of abuse. In case it is detected the size and symptoms of it will determine what need to be done. In case the size is below 6 mm no intervention generally required. Similarly asymptomatic aneurysm do not require intervention. In case they become symptomatic or larger than coiling is generally preferred modality of treatment.
I hope this gives you more assurance which is definitely required considering the positive family history.
Thanks and regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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