Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with a doctor.
Without the ability to examine and obtain a history, I can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.
There are multiple causes for white matter signal changes on MRI. Most often, these are due to what is called "chronic small vessel disease", literally meaning diseased small vessels that supply blood flow to the brain, as your neurologist was indicating. This is not an uncommon process in the brain and increases with age. This is not a disease in and of itself but rather is a reflection of unhealthy blood vessels, damaged by years of plaque build-up. This is most often due to a combination of several factors including the following: high blood pressure, diabetes, smoking, and high cholesterol. If these factors are well controlled, the damage to the brain can be stabilized and further damage prevented. I understand that you do not have migraines, HTN, or DM. Other causes can
Other causes of white matter changes on MRI can usually be distinguished based on history and symptoms, such as symptoms of neurologic deficit (for example arm weakness or difficulty walking etc). These can also be distinguished based on the MRI appearance. These include, but are not limited to, multiple sclerosis, other demyelinating disease, and inflammatory processes such as vasculitis.
I would continue discussing the results with your neurologist. It is difficult to provide you with more specific information given that we are unable to view images.
Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.
I've diagonised as follows in my MRI report.
MRI of the lumbar spine shows early spondylotic changes and disc dessication.
There are centrolateral disc protrusion at L4-L5, L5-S1 levels causing Right L5 and left S1 nerve root mild compression at the corresponding lateral recess level.
The rest of the finding are normal.
Could you please enlighten me on the seriousness of my above condition. Should I be in bed rest as suggest. Iam a frequent traveller due to professional demands.
Dr. Newey -
Thanks for your comments. Since I submitted my question, my doc has informed me I had a homocysteine of 26.2 (grandfather dropped dead of a heart attack when he was my age), and my B12 is borderline. Other than Vitamin D coming back low and Alkaline Phosphatase coming back high . . . my blood work looks really good (except for those three tests).
Could the homo level be indicative of artheroscolrosis (sp?), especially with a borderline B12???
And was the radiologist's comments regarding doing an MRI w/contrast because he doesn't know the person/history . . . and my doc ignored it, 'cause he does?