MRI Brain Results : Please help

[Alexis8368]

Hello:

I am 43 y.o female. I had a neck and brain MRI earlier this week and have the results. I do not take any medications other than Ambien to sleep.

I have made an appointment for a Neuro but have to wait three weeks to see him.
My primary ordered the MRI and when she had the results she said to bring the films to a specialist for their interpretation.

I have always had poor balance, but I always attributed that to my scoliosis, for which I had spinal fusion surgery 16 years ago, 2 harrington rods were placed t1 thru t11.

I have had pain in my neck/head for years, and finally found out that I could have an MRI, so we went for it.
Lately I have had frequent dizzy spells, more issues with my balance being off and more headaches.

Most of these issues I have thought pertained to the neck problems from the spinal fusion.

Anyway, the MRI of the brain came back 'interesting'.. I would like any feedback from the forum on what the findings may indicate. I am already aware of a possible MS link, based on 'other' annoying symptoms that I have had for quite some time that I attributed to age.

Please tell me what you think:


Clinical Indications: Headaches, dizziness and imbalance
MRI of the brain was performed on a 3.0 Tesla Ultra High Field Wide Bore Verio MRI with multiple multiplanar pulse sequences obtained prior to and following the intravenous contrast administration of 7 cc Gadavist.

The ventricular system is normal in size and position. Multiple foci of elevated signal intensity are noted within the subcortical white matter. No intratentorial or corpus callosal involvement is identified. No focal mass, mass effect or extraaxial collecitons are identified. No abnormal enhancement is present. The orbits and paranasal sinuses are within their normal limits.

Mild left mastoid air cell inflammatory changes are identified.

Along the left aspect of the frontal soft tissues there is a focus of susceptibility artifact.

Impression:
Multiple foci of increased signal  intensity  within the subcortical white matter on Flair and T2 weighted images represents a nonspecific finding. Differential diagnosis includes demyelinating, infectious/inflammatory and ischemic processes.

I appeciate any help!
Thanks!
Alexis

[Alexis8368]

Thank you for the reply.
I do have an appointment scheduled, but have to wait 3 weeks.

Regarding the symptoms you mentioned I do experience about half of them. Due to the spinal fusion I do not think I will be able to have a spinal tap (or wishful thinking on my part!)

I have had some strange blood results come back in the past couple of years, the most recent being 'Anti-dsDNA' out of range at a 7. and I think my Ana-choice was positive at some point last year.

Not sure if that has anything to do with this result.

[Dr Sharma]

Hi there. You need to consult a neurologist for evaluation of multiple sclerosis a chronic demyelinating disorder and is a diagnosis of exclusion. The symptoms of multiple sclerosis are loss of balance, muscle spasms, numbness in any area, problems with walking and coordination, tremors in one or more arms and legs. Bowel and bladder symptoms include frequency of micturition, urine leakage, eye symptoms like double vision uncontrollable rapid eye movements, facial pain, painful muscle spasms, tingling, burning in arms or legs, depression, dizziness, hearing loss, fatigue etc. The treatment is essentially limited to symptomatic therapy so the course of action would not change much whether MS has been diagnosed or not. Apart from clinical neurological examination, MRI shows MS as paler areas of demyelination, two different episodes of demyelination separated by one month in at least two different brain locations. Spinal tap is done and CSF electrophoresis reveals oligoclonal bands suggestive of immune activity, which is suggestive but not diagnostic of MS. Demyelinating neurons, transmit nerve signals slower than non-demyelinated ones and can be detected with EP tests. These are visual evoked potentials, brain stem auditory evoked response, and somatosensory evoked potential. Slower nerve responses in any one of these is not confirmatory of MS but can be used to complement diagnosis along with a neurological examination, medical history and an MRI in addition, a spinal tap.  Therefore, it would be prudent to consult your neurologist with these concerns. Take care