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MRI of Brain
This is the MRI report of my uncle (age - 46)
PROCEDURE : -
T1, PD & T2 weighted multi planar spin echo images taken including T1 & T2 FLAIR, GRE as well as diffusion weighted sequences.
FINDINGS :-
Diffusion weighted images are showing no focal parenchymal area of restricted diffusion.
Cerebral hemispheres are showing few small chronic ischaemic foci at bilateral frontal & parietal deep white matter regions producing no mass effect.
Lateral Ventricles, sylvian fissures and cortical sulci are mildly dilated bilaterally.
Rest of the brain parenchyma, ventricular system and subarachnoid spaces otherwise appear normal. No shift of midline structures noted.
Pituitary gland, infundibulum and optic chiasma are normal.
Posterior fossa shows normal signal pattern of the brainstem and the cerebellar hemispheres with the fourth ventricle in midline.
Cerebello - pontine angle and internal auditory canal including VII-th and VIII-th nerves appear normal on both sides.
Incidentally, minimal inflammatory mucosal thickening noted within bilateral paranasal sinuses.
IMPRESSIONS : -
The non contrast MRI findings of brain are suggestive of few small chronic ischaemic foci at bilateral frontal & parietal deep white matter regions with features of mild diffuse cerebral atrophy.
What should be our line of action/treatment ?
PROCEDURE : -
T1, PD & T2 weighted multi planar spin echo images taken including T1 & T2 FLAIR, GRE as well as diffusion weighted sequences.
FINDINGS :-
Diffusion weighted images are showing no focal parenchymal area of restricted diffusion.
Cerebral hemispheres are showing few small chronic ischaemic foci at bilateral frontal & parietal deep white matter regions producing no mass effect.
Lateral Ventricles, sylvian fissures and cortical sulci are mildly dilated bilaterally.
Rest of the brain parenchyma, ventricular system and subarachnoid spaces otherwise appear normal. No shift of midline structures noted.
Pituitary gland, infundibulum and optic chiasma are normal.
Posterior fossa shows normal signal pattern of the brainstem and the cerebellar hemispheres with the fourth ventricle in midline.
Cerebello - pontine angle and internal auditory canal including VII-th and VIII-th nerves appear normal on both sides.
Incidentally, minimal inflammatory mucosal thickening noted within bilateral paranasal sinuses.
IMPRESSIONS : -
The non contrast MRI findings of brain are suggestive of few small chronic ischaemic foci at bilateral frontal & parietal deep white matter regions with features of mild diffuse cerebral atrophy.
What should be our line of action/treatment ?
Best Answer
MEDICAL PROFESSIONAL
Hi there. The MRI changes are suggestive of small vessel ischemic disease, hypertensive change or a demyelinating lesion. Consult a physician for checking hypertension etc causing these MRI lesions. MS is a chronic demyelinating disorder where the disease phase is characterized by active phase and remissions. It has multiple symptoms and signs 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. Hope this helps. Take care.
I recently got MRI Scan of my father. The reports states following impressions:-
- FEW SMALL FOCI OF ALTERED SIGNAL IN BILATERAL FRONTAL & PARIETAL WHITE MATTER, LIKELY TO REPRESENT SMALL VESSEL ISCHEMIC CHANGES.
- MILDE DIFFUSE CEREBERAL ATROPHY.
I need help regarding what exactly is the problem? How serious it is? How to cure it?
Thank you,
Akarsh Jain
- FEW SMALL FOCI OF ALTERED SIGNAL IN BILATERAL FRONTAL & PARIETAL WHITE MATTER, LIKELY TO REPRESENT SMALL VESSEL ISCHEMIC CHANGES.
- MILDE DIFFUSE CEREBERAL ATROPHY.
I need help regarding what exactly is the problem? How serious it is? How to cure it?
Thank you,
Akarsh Jain
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