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What Does The Following MRI Report Suggest?
Question: MRI report states:'Patchy foci of subcortical and deep white matter signal hyperintensity within the frontal and to a lesser extent parietal and temporal lobes'
I am 53,have been concerned about MS. Mom had Altzheimers. No elevated BP,no elevated Cholesterol.
Neurologist appointment only in 2 months time!!
What comment do you have about this?
I am 53,have been concerned about MS. Mom had Altzheimers. No elevated BP,no elevated Cholesterol.
Neurologist appointment only in 2 months time!!
What comment do you have about this?
Brief Answer:
Small vessel disease more probable.
Detailed Answer:
I read your question carefully and I understand your concern.
That description speaks of white matter changes in your brain. The origin of these changes can be variable and to judge some more info would be appreciated including all symptoms, their evolution in time (since you say to have been worried about MS for some time I imagine you've had other symptoms before), other conditions such as high blood pressure, diabetes, smoking, high cholesterol, rheumatological conditions (lupus, rheumatoid arthritis etc), infections, past traumatic injuries, any particular family history. Also regarding the MRI report it would be useful to know whether it says something else such as enhancing after the administration of contrast for example.
From the little info I have till now the most common and probable cause are changes of the small blood vessels in your brain, otherwise called small vessel disease, its progression can be slowed by controlling vascular risk factors and aspirin. Multiple sclerosis is another possibility but apart from missing localization in some characteristic location for MS, it is unlikely at your age, usually manifests earlier.
I remain at your disposal for further questions, possibly with the info above.
Small vessel disease more probable.
Detailed Answer:
I read your question carefully and I understand your concern.
That description speaks of white matter changes in your brain. The origin of these changes can be variable and to judge some more info would be appreciated including all symptoms, their evolution in time (since you say to have been worried about MS for some time I imagine you've had other symptoms before), other conditions such as high blood pressure, diabetes, smoking, high cholesterol, rheumatological conditions (lupus, rheumatoid arthritis etc), infections, past traumatic injuries, any particular family history. Also regarding the MRI report it would be useful to know whether it says something else such as enhancing after the administration of contrast for example.
From the little info I have till now the most common and probable cause are changes of the small blood vessels in your brain, otherwise called small vessel disease, its progression can be slowed by controlling vascular risk factors and aspirin. Multiple sclerosis is another possibility but apart from missing localization in some characteristic location for MS, it is unlikely at your age, usually manifests earlier.
I remain at your disposal for further questions, possibly with the info above.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I have uploaded the Radiologist's report. In reply to your answer,I will answer each:"other conditions such as high blood pressure"- NO, "diabetes"-NO, "smoking"-NEVER, "high cholesterol"-NO," rheumatological conditions (lupus, rheumatoid arthritis etc)"- Tested for RA as I have sore hands and feet especially upon rising-None of rheumatoid factors tested +,some degeneration of some of the joints in hands and feet.
I did however have a CRP of 9( at the time had a pyelonephritus) infections," past traumatic injuries"- born 7 months prem- No incubators or medications at the time; Have been in mva,fell of my horse a number of times as a kid
" any particular family history"- Mother had Alzheimers,PAD, Dad COPD,high cholesterol,I think high BP.He also had tremor in his hands from a reasonably young age( not Parkinsons) My grandmother died of CHF.
All my kidney function, liver function tests ( and a number of other tests)have been normal. I am on HRT Kliovance( nightsweats and hot flushes were debilitating)
Symptoms over the years that made me think MS:Some have been episodic and others have persisted.
Muscle weakness( even when fit struggle to cycle up hills,now unfit feel as if I've done a marathon walking up a ramp or a flight of stairs, balance problems( boyfriend thought I was drunk as I sometimes just lost my balance),vertigo,memory problems- struggling to learn, focus. Can't comprehend complex issues. Cannot cope in very stressful situations ( interviews where I have to present a clinical paper of a product I don't know or have not had time to prepare.
Cannot be in sauna or tolerate heat,noise. I often cannot remember a word and sometimes turn a syllable around.Used to be very good at maths now struggle to do fairly simple things.( forgot the word)
Sometimes when I walk downstairs I will loose my spatial awareness and miss a a step.
in the mornings I have a tremor in my head or arm/hand so that I have to focus hard on aiming for my mouth.
Eyesight deteriorating sometimes not focussing probably just 'old age'
Tingling in hands from time to time(no numbness) no tingling in feet, I often have bruises and cuts I did not feel 'happening'
Have had an episode in 2009 when my right side of my face and arm went numb;had total memory loss for a number of hours. MRI and EEG showed nothing.
I always feel as if I have cottonwool in my head. I wake up tired every day. Have not slept well for years-use half a Stilnox or Imovane on occasion, not regularly.
Muscle and joint aches. Vit D deficiency diagnosed a few years ago.
Now what do you think?
I did however have a CRP of 9( at the time had a pyelonephritus) infections," past traumatic injuries"- born 7 months prem- No incubators or medications at the time; Have been in mva,fell of my horse a number of times as a kid
" any particular family history"- Mother had Alzheimers,PAD, Dad COPD,high cholesterol,I think high BP.He also had tremor in his hands from a reasonably young age( not Parkinsons) My grandmother died of CHF.
All my kidney function, liver function tests ( and a number of other tests)have been normal. I am on HRT Kliovance( nightsweats and hot flushes were debilitating)
Symptoms over the years that made me think MS:Some have been episodic and others have persisted.
Muscle weakness( even when fit struggle to cycle up hills,now unfit feel as if I've done a marathon walking up a ramp or a flight of stairs, balance problems( boyfriend thought I was drunk as I sometimes just lost my balance),vertigo,memory problems- struggling to learn, focus. Can't comprehend complex issues. Cannot cope in very stressful situations ( interviews where I have to present a clinical paper of a product I don't know or have not had time to prepare.
Cannot be in sauna or tolerate heat,noise. I often cannot remember a word and sometimes turn a syllable around.Used to be very good at maths now struggle to do fairly simple things.( forgot the word)
Sometimes when I walk downstairs I will loose my spatial awareness and miss a a step.
in the mornings I have a tremor in my head or arm/hand so that I have to focus hard on aiming for my mouth.
Eyesight deteriorating sometimes not focussing probably just 'old age'
Tingling in hands from time to time(no numbness) no tingling in feet, I often have bruises and cuts I did not feel 'happening'
Have had an episode in 2009 when my right side of my face and arm went numb;had total memory loss for a number of hours. MRI and EEG showed nothing.
I always feel as if I have cottonwool in my head. I wake up tired every day. Have not slept well for years-use half a Stilnox or Imovane on occasion, not regularly.
Muscle and joint aches. Vit D deficiency diagnosed a few years ago.
Now what do you think?
Brief Answer:
Read below.
Detailed Answer:
Thank you for providing more info.
That MRI report suggests precisely what I already done, that those changes are most likely due to small vessel disease, which means narrowing of small blood vessels causing ischemic changes in the areas they supply with blood. These changes develop to a certain degree in many people with aging, however at your age it seems that they are developing at a faster rate than usual. That can be due often to genetic factors as well factors like blood pressure, diabetes, smoking etc (the vascular risk factors the report suggests to correlate with) but which are not present in your case. Rheumatological conditions are another common cause which apparently has been excluded in your case. So they are most probably related to hereditary factors. Treatment to slow the process down apart from checking for those vascular risk factors consists also in the addition of small dose of daily aspirin. It is a condition which has developed over many years, not likely to have any abrupt manifestations, so you can safely wait for the neurologist appointment in two months.
Your progressive clinical history of gait, memory and other cognitive issues, mood changes corresponds to small vessel disease as well.
MS is to be excluded both from the not typical history as well as the type of lesions.
One other potential cause to be considered for the changes on MRI might be post traumatic changes considering your history of MVA and other traumas, however small vessel disease is more likely considering the evolution in the last few years.
I hope to have been of help.
Read below.
Detailed Answer:
Thank you for providing more info.
That MRI report suggests precisely what I already done, that those changes are most likely due to small vessel disease, which means narrowing of small blood vessels causing ischemic changes in the areas they supply with blood. These changes develop to a certain degree in many people with aging, however at your age it seems that they are developing at a faster rate than usual. That can be due often to genetic factors as well factors like blood pressure, diabetes, smoking etc (the vascular risk factors the report suggests to correlate with) but which are not present in your case. Rheumatological conditions are another common cause which apparently has been excluded in your case. So they are most probably related to hereditary factors. Treatment to slow the process down apart from checking for those vascular risk factors consists also in the addition of small dose of daily aspirin. It is a condition which has developed over many years, not likely to have any abrupt manifestations, so you can safely wait for the neurologist appointment in two months.
Your progressive clinical history of gait, memory and other cognitive issues, mood changes corresponds to small vessel disease as well.
MS is to be excluded both from the not typical history as well as the type of lesions.
One other potential cause to be considered for the changes on MRI might be post traumatic changes considering your history of MVA and other traumas, however small vessel disease is more likely considering the evolution in the last few years.
I hope to have been of help.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Brief Answer:
Read below
Detailed Answer:
Your questions are very correct. Unfortunately yes, it means that there is a greater likelihood both for developing dementia and an increased chance of stroke in the future. It is not a sentence and I hope it won't happen to you, but the chances are higher than the average healthy person of your same age.
I hope things will work out for the best.
Read below
Detailed Answer:
Your questions are very correct. Unfortunately yes, it means that there is a greater likelihood both for developing dementia and an increased chance of stroke in the future. It is not a sentence and I hope it won't happen to you, but the chances are higher than the average healthy person of your same age.
I hope things will work out for the best.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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