Gliosis again? Can anyone clarify if i need to worry about this?

[missy142]

Hi,

I saw the post of gliosis vs. demylination but still not sure if its something to worry about or not.  My brain MRI reads

"There is a single area of abnormally increased signal on both the FLAIR and T2 weighted images in the white matter adjacent to the atria of the right lateral ventricle.  The lesion measures 2mm in diameter, is not associated with any enhancement, mass effect, diffusion restriction or edema."

"Single area of abnormal signal in the white matter adjacent to the the atria of the right lateral ventricle which appears to be an incidental area of nonspecific gliosis and of questionable clinical significance."

Neuro hasnt read this yet, i got a copy somehow, he will call me later and probably say its nothing, they always seem to say "oh thats nothing".  :o)  

Any thoughts?
thank you

missy

[mangelastro]

The Gliosis is a proliferation of cells.  Not all that important. I do know this, the mind can do some terrible things to the body and it can also make those considerations disappear!  Stop thinking so hard about it, it is NOT cancer.
Relax and enjoy your life, do not worry about a small bunch of non specific cells.  It is NOT a tumor.  Until you actually have a health issue, other than headaches, the headaches are not caused by the gliosis, it is being caused by your anxiety that is provoking your pain.  I should know, I had nerve damage of the left leg caused by a surgeon perforating it.  I learned all kinds of calming treatments, biofeedback, etc.  Learned to live with it and moved on.  I had a large brain tumor, meningioma, my glosis is aside where the brain tumor was (since removed).  I have pain back there as well, it's scar tissue from the surgery.  Try not to think the worse.  The glass is really not half empty, but half full.
Peggy  

[ortech1958]

I wish I had a glass.

[Aasha_Patel]

Any one can say me about gliotic area. My brain MRI report says that "small gliotic area is seen in right basi-frontal lobe". My Nurophysician said me not to worry. But I am confused and tense to take this. Please any body who know about this, explain me what is this and what i have to do?

[supermum_ms]

I'm sorry but you have posted in the MS community forum, we are not medically trained so we probably wont be able to give you what your looking for but personally if i was you, i'd try and find the best neuro in India and get a second opinion.

[sandy_tosh]

Hi I have a query - My contrast MRI (brain) report says, "Gliosis in the right anterior frontal lobe in parasagittal location" is there anything to worry. I am 35 years old Male a sports man (taekwondo). Doc is scaring me and saying it cud lead to paralysis or other attracts which cud make me un-conscious temporarily and have advised not to drive, exercise or stay alone...I am bit worried I stay alone away from family. Can any one suggest pls !!

[dhara64]

my daughter suffered head injury at the age of three and was complaining headache .today she is 15.the mri shows gliosisin the left basifrontal region .what wouid be its consequences in future ?

[aparker24]

I recently had an MRI of my brain/neck and the report mentioned gliosis.  I was referred to a neurosurgeon but told it could take 30 days for him to call me and schedule an appt.  This is what my report says...if anyone has insight please let me know.

Brain:  small area of T2 hyperintensity about the anterior horn of the right lateral ventricle.  May represent an area of gliosis or appendymitis granularis.

Neck:  right paracentral and central disc herniation at C4-5 which causes severe neural foraminal narrowing on the right and compresses the cord in the right aspect of the thecal sac.

I understand the disc herniation but the brain thing has me confused.  I have an aunt with MS so I hope this isn't the beginnings of that.

[missy142]

Quix,  (and all sweet people responding:o)

Thanks for your input.  My neurologist has been very thorough thus far and the spine stuff seems to be the culprit of all.  I believe the only reason they even were ruling out all else is because according to my neurosurgeon and neurologist the cord compression I have in a couple of areas they deem not enough in 90-99% of cases to cause the extreme bilateral leg weakness i have experienced bouts with 3 times now since March. I wish they could be in my body for a 1/2 a minute, they wouldnt have to question it further I suspect.

It can be so bad that I look like I have Cerebral Palsy according to one of my doctors.  My calf muscles get hypertonic and have hyperreflexia.  No lesions on spine.

Nutshell: Central C5/6, C6/7 herniations, C6/7 nerve root compression, C5/6 spinal cord compression, Spinal stenosis, broad based spondylitic ridge., blah, blah. Right paracentral  T7/8 herniation with mild cord compression at that level.  The MRI says no nerve root compression but I have pain from sternum wrapped around to mid back at T7/8 level intermittent.  Small central L5/S1 herniation and EMG lower ext. deemed to be chronic L4/5 nerve irritation.

So this past Wednesday I got the same feeling again of muscle weakness and within hours could barely walk or hold myself up.  Neurologist just prescribed Zanaflex which after first dose almost fell asleep in my food, seems to be working. I am up and walking again much faster than last 2 "attacks".

I am to have soon another cervical MRI flex/ext.  to see if I  am compressing my cord upon well flex and extension.  Most of the paresthesia's in my lower extremities just come and go (least of the problems, at least they dont hurt)

So my neurologist said my dx is Cervical Myelopathy so obviously it is from herniations and spondylitic changes.  Although he says "Well we can never be absoultely sure if its causing all your symtoms".   I dont know WTF that means, but I believe they are astounded that i guess at 47 with the amount of compression I have that it could be causing all this fuss, thats why testing for all other possibilites..  But it has wrecked my life since last year.  the only thing under control is the crushing UE radicular pain.  However I cannot function not being able to walk every other week plus god only knows if Im doing permanent damage to my nerves and cord.  Bummed about all this, its scary.

Signed

(Its ***** to NOT be in the 90-99%) aka Missy

[Quixotic1]

Gliosis is basically scarring from some unknown insult.  When you see a scar on the skin you usually can't tell exactly what caused the initial wound, except for gunshots, but you get my meaning.  There are truly dozens of things that can cause tiny areas of gliosis from injuries or infections before birth, to head trauma, to a single migraine, to elevated BP, to adult infections and on and on.

A lesion of 2mm is tiny and too small to be "officially" thought of as an MS plaque.  That doesn't mean that it isn't from MS, but 2mm and less have so many other possibilities.  In and of itself, I don't think it is worthy of worry.  It is true that losts of people have one or two tiny lesions of no know clinical significance.

I tried reading several of your old posts since you joined (you've been a busy woman!) and see that you have some mildish cord compression and there is controversy about whether that is sufficient to cause the bouts of extreme bilateral leg weakness you have had.  the lesion that caused this symptoms would have to be in the cord, not the brain.

I don't have a feel for whether you might have MS superimposed on all the spinal stuff you suffer from.  One tiny lesion is not strong evidence.  My inclination would be to focus on the spinal instability and injuries that you know you have.  Once that is as clarified as it can be, then assess whether any of the symptoms you have CANNOT be explained by spinal disease.  Then, and only then look again at the brain.  At minimum, if there are no new symptoms that would refer to areas higher in the CNS than your spine injuries, you need a repeat MRI in 6 to 12 months.

To all - I really enjoyed the discussion between Jan, CNursey, and Pat.  Good intellectual discussion covering a realm of important topics.

Quix

[BOK2Bjan]

Hi, how frustrating!  Was this your first MRI?  I don't remember.  If it was, even though he sounds a bit "rude", you will need an additional MRI after a few months anyway.  Your MRI needs to show that you have new lesions or a previous lesion has changed.  But you must have lesions in at least 2 different areas of the CNS to show that the disease is active in more than one location and is changing over time.  So, regardless of what the first MRI showed, you'd still need a second one.  That is one of the frustrating part about getting a diagnosis - at best, it takes months.  But at least you have the first one, as well as clinical evidence of abnormal neurological symptoms.  Now you'll need a follow-up MRI.  I sound like I'm wanting you to be diagnosed - NO WAY.  I hope you don't.  But I also hope you are able to find out what is causing your symptoms.  Make sure to get the follow up MRI - 6 months would be fine, unless you have reason to think you've had a major change before then.  I went through a great deal of frustration on my way to the Systemic Sclerosis diagnosis, so I know how frustrating it can be.  I'm almost glad I didn't know about the ms until it was a sure thing.  Although that meant not getting treatment.  Keep a journal of your symptoms and follow up.  That's all you can do at this point.  I empathize and wish you the best.

Blessings, Jan

[CheeserNurse]

Thanks for that info, but what makes me the most frustrated is that I have the lesions (abnormal MRI), the NEUROLOGICAL SYMPTOMS, and the abnormal assessment findings...he just dismissed me and said since the MRI didn't fit the 'classic' MS lesions, to come back when my symptoms got worse and go from there!

[BOK2Bjan]

There are some congenital syndromes with gliosis.  And the disease from the cow is viral. So he is right.  However, you would have to be diagnosed with those very rare conditions and I think you'd know by now.  There are people who "supposedly" have anomalies that show up as white spots, but that aren't clinically significant.  But this is also a way of saying we just don't understand it yet.  Imaging of the brain is a very volatile and recent science.  Most doctors in practice today have seen so many changes in technology that they are seeing things they don't yet fully understand.  The medical knowledge has to catch up with the imaging technology.  That's why they often are saying "of unknown significance" or "may be imaging debris" etc.  The stronger the machine, the more is seen that they aren't always sure what it is.  And I couldn't agree more that it is very frustrating.  When I was first told I even had the lesions, my doctor said that they might be nothing - just debris, or normal anomalies, etc.  I didn't give it any thought.  I hadn't even been told I'd had lesions for years.  BUT, that's why I was mighty surprised to have a neurologist waltz into my hospital room and announce that I had a slam dunk dx of ms.  I wasn't even curious about THAT particular disease.  I'd already been dx with enough.  SURPRISE!

Anyway, I hope I made what I said clear.  Your neurologist might be wrong about your case - no doubt - but what he said is true in some cases.  So, don't be too hard on him.  Blessings, Jan

[CheeserNurse]

Okay, reading this makes me wonder WHY ON EARTH my last neuro. would tell me that some people can be BORN with lesions (white spots) in the brain--gliosis, too?? I HAVE NO HISTORY OF BRAIN INJURY OR ANYTHING....yet, my neuro dismissed me and did say that some people can be BORN with these lesions or get them from a virus, etc...still, no history of that either...I'm 22, not 102, so I don't have 'age spots.' Gooooodness, I cannot wait to see the new neuro. June 24.

All so frustrating and confusing!!

[BOK2Bjan]

Hi missy and all,

Gliosis is the term used for scar tissue that replaces the healthy tissue after brain injury.  The injury can be almost anything.  Head trauma, stroke, MS, or some rare congenital abnormalities in infants and premies.  Or, you could eat cow brains or CNS tissue of a cow that's got an infection, but that's not a frequent occurrence!! lol  Those good old vague terms used by radiologists.  BUT, they can occur in areas that cause symptoms such as parasthesias, etc. so, it's never really "insignificant".  It's just not "conclusive".  The diagnostic nightmare marches on.  Frustrating!  I send you my best.  Blessings, Jan

[missy142]

Hi Pat!
Nice to talk with you. 15mm whooooh!  Do you have any lesions on your spine?  You know in the body of the report of mine it says "lesion" then refers to it as gliosis?? so again to me this sounds like they are interchangeable terms right?  

My neurologist god bless em, had directly spoken to me to tell me he was still  examining the evoked potentials and asked me if the tech did the medial nerve twice?  and I said not that I know, anyway he said he needs to evaluate it further, i guess later after done with patients and will call me back, when? I dont know..  He didnt know I had the brain MRI report, he has already seen the films.  I had the MRI place fax over the report again to him as he said he didnt have it  and his secretary called me back saying "Oh dr. **** says "nothing has changed"  Well i had a brain MRI last month and they never even mentioned this! so what does he mean nothings changed:o)

I have a diagnosis of cervical spondolitic myelopathy, i have spine issues so it has been difficult with diagnostics.  there doesnt appear to be any other positive diagnositics of  MS, so as I do have the spine issues they are contributing my symptoms to the cord compression.

But that being said it doesnt explain this gliosis or lesion right??  I dont know.
What are ur symptoms and what esle has md said to you, just follow in 4 months?

you can PM me if you like to discuss further or if you like just here.

thanks,
missy

[6-paq]

I posted the recent "gliosis vs demyelination" thread as my latest MRI report had mentioned the term.

Your spot is in the same location as my "gliosis" (atria of the right lateral ventricle).  Mine is 15 mm.  I've also read that gliosis can be associated with MS, thus my confusion.

Mine MRI hasn't changed at all in over 2.5 years.   My neuro called with the latest results (after I already had my report from the facility in hand ~ I've very impatient) and never mentioned "gliosis".   He just said that there is no change (which he said was good news), but it is still something to be concerned about and I need to be monitored.  

After my first MRI, I was told by my neuro that my "gliosis" or plaque or whatever it is was in the "right location" for an MS plaque.   The last report mentions "Stable gliosis or demyelination of unknown significance.  Again, Multiple Sclerosis cannot be excluded."   Therefore, I'm still being followed every 4 months as "possible MS" until more lesions show, I exhibit new symptoms, or a deficit appears on neuro exam.

I'm curious to hear what your neuro has to say.   My guess is that this won't get you any closer to a diagnosis.  What are your symptoms?  

Take care,
Pat :-)

[Heather3418]

This is the definition I found for gliosis.  After reading it, it CAN be associated with MS.  So your doctor make look at is differently, since he supposedly is looking for MS.

definition:  Gliosis and neuronal loss in certain brain regions are findings seen in various neurodegenerative disorders such as Alzheimer's disease, Korsakoff's syndrome, multiple system atrophy, prion disease, multiple sclerosis (after an acute attack) and AIDS dementia complex. It can also be found in Parkinson's disease and Huntington's disease.

I hope other members of the Forum comment on your post.  Maybe they can enlightened both of us on the subject.

Best Wishes,
Heather