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What does the following brain MRI report suggest?

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Posted on Mon, 25 May 2015
Question: I just received results from a brain MRI taken because of deep pain behind my eye and behind my ear. The pain seems to be constant sometime more or less. 4 months of this. The report said: Probable minimal small vessel scan change in the periventricular white matter. There is no acute ischemia on diffusion weighted imaging. There is ectasia of the basilar tip measuring 4 mm. Further evaluation of the circle of Willis might be best made with MRA. There is no hemorrhage or mass. There is minimal ethmoid sinus disease. My DOB is 2/08/48 and I am 5'4" and 179 lbs. I sleep with a CPAP for 10+ years and back problem 1) Narrowing and spondylosis demonstrated at C4-5 and C5-6 suspicious for discogenic disease 2) Dextroscoliosis 3) Multilevel disc space narrowing suspicious for discogenic disease 4) Levoscoliosis with no evidence of fracture. I am limited to 10 min a day of non weight bearing exercise. Recent PT caused severe sciatic pain leading to an epidural to stop the pain. Recent shot into back of neck to stop that pain but it hasn't. I'm just trying to figure out if all of this is related and what are my chances for stroke and or aneurysm. Diet is limited to no gluten, eggs, dairy or soy. I have been told I am a difficult case more than once.
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Answered by Dr. Erion Spaho (2 hours later)
Brief Answer:
Two conditions not related to each other.

Detailed Answer:
Hi XXXX.

I have read your question and understand your concerns.

Headaches you are experiencing could be related to ethmoid sinusitis, or small brain vessels disease.

Small vessels disease is a conseguence of high blood pressure.

According to MRI results, there in no bleeding or stroke, so headache is not related to any aneurysm.

Stroke risk is related directly to hypertension, so it is the risk for aneurysm presence.

MRA is needed to evaluate correctly the basilar ectasia, is it an aneurysm or not, and to evaluate other brain vessels for presence of aneurysms.

One thing is sure: there is no ruptured aneurysm ( or subarachnoidal hemorrhage).

In the other hand, there is degenative spine disease not related to brain condition.

Treatment about degenative spine disease consists on antiinflamatory drugs, exercises designed to increase muscles strength and relieve joint loading.

When these measures fail to improve symptoms, or there is worsening of neurological findings ( spasticity eg.) correlated to imaging studies findings, decompressive surgery +/- spine stabilization is needed.

Of course, these issues should be discussed with your treating Doctor.

There is no relation between your restricted diet, or CPAP treatment.

Hope I've helped you. If you have further questions or clarifications feel free to ask.
If no, you can close the conversation and rate the answer.
Above answer was peer-reviewed by : Dr. Neel Kudchadkar
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Answered by
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Dr. Erion Spaho

Neurologist, Surgical

Practicing since :2004

Answered : 4386 Questions

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What does the following brain MRI report suggest?

Brief Answer: Two conditions not related to each other. Detailed Answer: Hi XXXX. I have read your question and understand your concerns. Headaches you are experiencing could be related to ethmoid sinusitis, or small brain vessels disease. Small vessels disease is a conseguence of high blood pressure. According to MRI results, there in no bleeding or stroke, so headache is not related to any aneurysm. Stroke risk is related directly to hypertension, so it is the risk for aneurysm presence. MRA is needed to evaluate correctly the basilar ectasia, is it an aneurysm or not, and to evaluate other brain vessels for presence of aneurysms. One thing is sure: there is no ruptured aneurysm ( or subarachnoidal hemorrhage). In the other hand, there is degenative spine disease not related to brain condition. Treatment about degenative spine disease consists on antiinflamatory drugs, exercises designed to increase muscles strength and relieve joint loading. When these measures fail to improve symptoms, or there is worsening of neurological findings ( spasticity eg.) correlated to imaging studies findings, decompressive surgery +/- spine stabilization is needed. Of course, these issues should be discussed with your treating Doctor. There is no relation between your restricted diet, or CPAP treatment. Hope I've helped you. If you have further questions or clarifications feel free to ask. If no, you can close the conversation and rate the answer.