MRI w and wout contrast 9mm punctate focus

[BJolie]

Any ideas for frustrated patient seen by reputable neurologist for car accident related facial palsy. Patient reports 2 opinions of inconclusive dx. Last year 2 MRI's. The results show Punctate focus of abnormal signal intensity within the posterior aspect of the right external capsule measuring 9mm, which appears hyperintense on both flair and fast spin-echo T2 weighted images and isointense on T1. No surrounding mass or edema. There is cortical atrophy prominent over the high frontal parietal convexity. . compatible with ischemic demyelination. Patient is a 52 yr. female. mild short term memory loss. History shows childhood concussion age 5. Family history of cancer, elevated BP and Diabetes, not present in patient.

[supermum_ms]

Hi and welcome,

Unfortunately your MRI findings don't read as being normal to me, why your neurologist hasn't been able to diagnose you with a specific something yet is really too hard to say, but i think you should specifically ask if my MRI is "compatible with ischemic demyelination" and i have cortical atrophy prominent over the high frontal parietal convexity, what exactly does that actually mean and what if anything can be done now to prevent future decline....

btw i was only reading some MS specific research the other day that stated the average size of demyelinating lesions was 7-10mm, so MS 'could be' one of the causes on your list but there is a lot more to diagnosing neurological conditions in general, off the top of my head 'ischemic demyelination' is most commonly associated with hypertension, causation is not always obvious so it can take some time to work it out.....hang in there!

Hope that helps......JJ

  

[HVAC]

We are not doctors we are patients who have MS.So are you wondering if it is MS? MS does not come from trauma like an accident. A concussion at 5 would have nothing to do with MS. Nor would another accident more recently. You can have an accident caused by MS but not the other way around. You could have MS and no one knows it until you have a MRI after trauma. MS lesions are not as big as 9mm that I know of. MS lesions look a certain way and are in particular areas of the brain like the ventricals.  MS usually has many lesions. Has a doctor mentioned MS? If you had MS at 52 you would probably have more symptoms and more lesions since MS usually starts at an earlier age. 52 is a little old but not impossible. People do get MS later. If you had atrophy with MS you would have more lesions and a lot more MS Symptoms.
    Have you had a MRI specifically for MS? The computer is set up specifically for MS. There are more pictures taken with and with out contrast. With my first MRI they were looking for something else so it was not MS protocal. The only thing that would lead to an idea of MS is demylenation.  But ischemic is not a MS term it is blood constriction. Unless a doctor said it could be MS I do not think you have to worry about MS.
Alex

[110Titus]

So you are wondering why they clearly see a lesion yet refuse to diagnose ?