Dr Deshmukh - please help w/ MRI

[BobiM]

My son, who is 38 was sent for an MRI for a brief visual distrubance that he explained as head pressure and then some loss of vision. He has no other symptoms and seems fine except for some gasto problems. I'm nervous this could be MS. I have 2 autoimmune diseases (celiac and Sjogren's) and my cousin has MS. Can you help translate this for me. His neuro appointment isn't until the very end of April.

The MRI interpretation said that there is no intra or extra-axial mass, hemorrhage, or fluid collection. There is no pathological enhancement. The ventricals are normal in size and configuration. A few scattered T2 and FLAIR hypersensitivites are subtle, and may represent vessels.

One of these FLAIR hypersensitivities is seen on image #17 of 23 in the left parietal lobe. Mildly prominent vessels are seen on the T2 weighted images, however, this finding is non-specific. An early demyelinating process is not excluded. The craniocervical junction appears normal. There is no restricted diffusion. The pituitary gland is unremarkable.

Normal intracaranial vascular flow voids are seen. Mucosal thickening is seen in the maxillary sinuses, ethmoid air cells, frontal sinuses, and sphenoid sinus.

IMPRESSION: 1. pansinusitis 2. A few subtle questionable T2 and FLAIR hypersensitivities are seen in the deep white matter. In a patient of this age group, a demyelinating process is not excluded.

[BobiM]

Thank you so very much for your post. This MRI is 1 week old. It was taken a few days after the visual problem occurred.He has had no other visual problems since then.  He has complained of headaches over the years. He had a 2 level spinal fusion and revision a few years ago. He also has mild Asperger's sundrome.

I so appreciate you answering my question. I've been very worried but feel a bit more confident in knowing it's at least possible that migraines can cause this problem.

[Abhijeet Deshmukh, MD]

Hello.

Looking at the report, we can not rule out MS. It may be a possibility. The lesions are not characteristic of MS, but they may still be seen with demyelination. Another strong possibility is that of migraines. Long standing migraine can show such a picture. Migraine is a neurovascular disease. Small blood vessels may be affected and may show T2 hyperintensities.

This report needs clinical correlation. How are his symptoms now? And how old is this MRI?

Regards