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MRI, next stop neurologist
First, let me thank everyone for this wonderful community. I have been stopping by and reading the community posts for a few weeks. The long and short of why I am here is that I am very confused about my radiologist report of my brain MRI. I had an auto accident on Christmas eve last year. At first I thought I was fine, just a stiff neck. About 2 weeks later I noticed some cog fog. Not too bad in the beginning. Each day was worse and by day 3, I was diagnosed with post concussive syndrome. My symptoms progressed to BAD vertigo, BAD cog fog, balance issues and my brain feeling so strange that I still can not describe it well. After about 5 weeks, I called my primary and asked for something for nausea as the vertigo was causing me to have nausea all the time. They had me come into the office, and after a few neurological tests the PA said she wanted me to go for MRI. The Impression portion of the report is as follows:
Scattered small hyper intense T2/FLAIR foci about the callososeptal interface on the left oriented perpendicularly. Early chronic small vessel ischemic changes/demyelinating disorder such as multiple sclerosis are the primary differentials. Recommend correlation with CSF analysis.
In the findings portion, nothing was found as far as concussion (which is not unusual). But it further states: A few small hyperintense T/2 FLAIR foci about the callososeptal interface on the left both along the anterior and posterior aspect with these foci measuring up to 5-6 mm.
There is more information in the findings portion of the report, but I don't think it offers anything else important. I do understand that the communities opinions are not medical, but I sometimes feel I get a better understanding from those who have been there done that.
My medical background prior to accident includes many symptoms that could be attributed to MS, but just as likely to be what I have been diagnosed with previously. My appointment with Neurologist is not until the end of April. While I am trying not to think about it all the time it is very hard.
Thank you for your thoughts and opinions.
Scattered small hyper intense T2/FLAIR foci about the callososeptal interface on the left oriented perpendicularly. Early chronic small vessel ischemic changes/demyelinating disorder such as multiple sclerosis are the primary differentials. Recommend correlation with CSF analysis.
In the findings portion, nothing was found as far as concussion (which is not unusual). But it further states: A few small hyperintense T/2 FLAIR foci about the callososeptal interface on the left both along the anterior and posterior aspect with these foci measuring up to 5-6 mm.
There is more information in the findings portion of the report, but I don't think it offers anything else important. I do understand that the communities opinions are not medical, but I sometimes feel I get a better understanding from those who have been there done that.
My medical background prior to accident includes many symptoms that could be attributed to MS, but just as likely to be what I have been diagnosed with previously. My appointment with Neurologist is not until the end of April. While I am trying not to think about it all the time it is very hard.
Thank you for your thoughts and opinions.
COMMUNITY LEADER
Hi and welcome,
You have a multiple medical conditions that 'could' account for most if not all of your symptoms prior to the post concussion, they may possibly even account for your "Scattered small hyper intense T2/FLAIR foci" MRI findings too. From my understanding even though "demyelinating disorder such as multiple sclerosis" was mentioned in your report, "Early chronic small vessel ischemic changes" would be the more common explanation in general.
I'm a bit surprised you didn't get an MRI of your cervical spine too, you've experienced common whiplash and concussion symptoms directly after having an accident, potential explanation coming from a structural spinal issue. To be honest at this stage i would think MS is just one possible in a list of possible's but what you already know about is definitely more likely....
Hope that helps......JJ
You have a multiple medical conditions that 'could' account for most if not all of your symptoms prior to the post concussion, they may possibly even account for your "Scattered small hyper intense T2/FLAIR foci" MRI findings too. From my understanding even though "demyelinating disorder such as multiple sclerosis" was mentioned in your report, "Early chronic small vessel ischemic changes" would be the more common explanation in general.
I'm a bit surprised you didn't get an MRI of your cervical spine too, you've experienced common whiplash and concussion symptoms directly after having an accident, potential explanation coming from a structural spinal issue. To be honest at this stage i would think MS is just one possible in a list of possible's but what you already know about is definitely more likely....
Hope that helps......JJ
1 Comments
JJ-
I have had 2 cervical MRI's. One pre accident, one post. I have not seen the report from those, but plan on getting them sent to me. I do know from seeing my 1st MRI, that there is a small one spot on my cervical spine, but my pain management DR has never really commented on it.
I have had 2 cervical MRI's. One pre accident, one post. I have not seen the report from those, but plan on getting them sent to me. I do know from seeing my 1st MRI, that there is a small one spot on my cervical spine, but my pain management DR has never really commented on it.
Hi - I echo the previous answers - that it is best to prepare to not learn a great deal at your first appointment. Your symptoms coming on gradually and staying for quite a while don't sound typical of MS - but then - that's really being presumptuous of me to make it sound like anything is TYPICAL. There certainly are symptoms that are more typical than others, however. The most characteristic feature of any symptom you may have is that it is usually not symmetrical - and lasts for a day or two up to a few weeks and then disappears. (The Relapsing Remitting Form, which is the most common) You might have many episodes, or you might have only one or 2. You might have the episodes be similar to each other - or they may be quite different. But it "usually" wouldn't be something that develops over time and lingers for a long time.
As for the MRI - I will just say that to diagnose MS, they must see demyelinating lesions in more than one location on more than one occasion, separated by time. So - one MRI is never conclusive. Sounds like they want to do a spinal tap, which can be a clue as well. Oligoclonal Bands show up in MS, but again, that result on its own is not conclusive.
Basically it can be a long, frustrating process for many people. I didn't go through that process, because I had other diagnosed diseases on which all of my neurological symptoms were erroneously blamed. When they had done enough MRIs to see the lesions showing up in multiple locations on multiple occasions, and had a spinal tap positive for the Bands - I got a very surprising diagnosis of MS. I was in the hospital for a blood patch for a spinal tap headache when I found out.
You mentioned that your previous symptoms could be due to what you had been diagnosed with previously. Do you mind saying what that condition is? I'm glad that you do not have long to wait until you can at least see a neurologist. I, also suggest that you write down your symptoms in a concise manner so you can review it with him or her, and be patient. I will also say that MS can be a very different disease for each person.
People know I have MS - but they don't know all the other diseases I have which cause me much more trouble. I have Secondary Progressive MS, but it still isn't what causes me the most disability. Yet, people always assume its the MS that's causing my problems! With Secondary Progressive, I have symptoms that stay without ever going away, but can still have flares.
So, I hope you are able to be at peace - knowing that you may not have answers for a while, but that even if you find out its MS - it doesn't necessarily mean a terrible future! I've known people who have had one episode and never had another. I certainly hope that any damage done by the accident has healed and that you have a healthy future.
Please keep us informed - and God Bless, Jan
As for the MRI - I will just say that to diagnose MS, they must see demyelinating lesions in more than one location on more than one occasion, separated by time. So - one MRI is never conclusive. Sounds like they want to do a spinal tap, which can be a clue as well. Oligoclonal Bands show up in MS, but again, that result on its own is not conclusive.
Basically it can be a long, frustrating process for many people. I didn't go through that process, because I had other diagnosed diseases on which all of my neurological symptoms were erroneously blamed. When they had done enough MRIs to see the lesions showing up in multiple locations on multiple occasions, and had a spinal tap positive for the Bands - I got a very surprising diagnosis of MS. I was in the hospital for a blood patch for a spinal tap headache when I found out.
You mentioned that your previous symptoms could be due to what you had been diagnosed with previously. Do you mind saying what that condition is? I'm glad that you do not have long to wait until you can at least see a neurologist. I, also suggest that you write down your symptoms in a concise manner so you can review it with him or her, and be patient. I will also say that MS can be a very different disease for each person.
People know I have MS - but they don't know all the other diseases I have which cause me much more trouble. I have Secondary Progressive MS, but it still isn't what causes me the most disability. Yet, people always assume its the MS that's causing my problems! With Secondary Progressive, I have symptoms that stay without ever going away, but can still have flares.
So, I hope you are able to be at peace - knowing that you may not have answers for a while, but that even if you find out its MS - it doesn't necessarily mean a terrible future! I've known people who have had one episode and never had another. I certainly hope that any damage done by the accident has healed and that you have a healthy future.
Please keep us informed - and God Bless, Jan
1 Comments
Thanks for the encouraging words everyone.
Jan, I have had sleep issues for the past 15yrs., Interstitial Cystitis, hypothyroid, carpal tunnel syndrome, PCOS, daily fatigue, constipation. I have a host of strange coming and going symptoms.
Icy hot skin, tingling/pins and needles, foot deforming cramps, occasional mild vertigo, and one spot on my arm that periodically has intense itching that can't be relieved, but goes away. I also have brief episodes of blurry vision.
Jan, I have had sleep issues for the past 15yrs., Interstitial Cystitis, hypothyroid, carpal tunnel syndrome, PCOS, daily fatigue, constipation. I have a host of strange coming and going symptoms.
Icy hot skin, tingling/pins and needles, foot deforming cramps, occasional mild vertigo, and one spot on my arm that periodically has intense itching that can't be relieved, but goes away. I also have brief episodes of blurry vision.
I am sorry you are going through all of this! As Alex said, April is here & the wait won't be long now. One thing I would encourage you to prepare for is that this appointment may not tell you anything definitive. Regardless of what this neurologist thinks is going on - MS or something else - it is a good idea to at least emotionally prep that the next course of action may be more tests or wait & see.
I wish you all the best. Let us know how the appointment goes & the outcome. The diagnostic phase is a really difficult time. Everyone here is in different stages of that and can really relate to the challenge of waiting.
Cheryl
I wish you all the best. Let us know how the appointment goes & the outcome. The diagnostic phase is a really difficult time. Everyone here is in different stages of that and can really relate to the challenge of waiting.
Cheryl
April is here so it won't be long. Only a neurologist can diagnose MS. No test rules MS in or out is part of the puzzle. It can take awhile with many tests to be diagnosed with MS. They have to rule out a lot of other conditions so lots of blood tests. Neurologists usually follow you for months or years even. My first MRI was classic MS yet it took me two years to be diagnosed with MS.
Write down your symptoms in a very short list. Let the neurologist do his thing then ask questions at the end. Neurologists are brainacs so they might seem dismissive but they are not.They do not explain. They will do a neurological exam which is reflexes and such. That is the most important part of finding MS. If you have a neurological condition it will be abnormal.
If you MRI was not done with MS protocol he might do another. A general MRI does not take as many shots. He might do it in a few months.
Alex
Write down your symptoms in a very short list. Let the neurologist do his thing then ask questions at the end. Neurologists are brainacs so they might seem dismissive but they are not.They do not explain. They will do a neurological exam which is reflexes and such. That is the most important part of finding MS. If you have a neurological condition it will be abnormal.
If you MRI was not done with MS protocol he might do another. A general MRI does not take as many shots. He might do it in a few months.
Alex
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