Thanks a lot. I'll second the comments made by Cindy and Phil and add that your tendency to answer all questions like you are talking to a peer is also very much appreciated. Even though the 'news' may be unwelcome, we have an excellent 'messenger'. I'll post more info after my consult. One other ? in the meantime, though. Cerebral vasculitis I believe is treated with high doses of steroids for up to a year. Does it have a similar MRI signature? What are the signs/symptoms of that illness and is an angiogram an absolute necessity for the dx? I'm a little wary of that as my dad stroked while his carotid was being opened up and spent the last 7 years of his life as an invalid. Thanks again..
Dear JBD3dmd:
I am sorry that you have signs and symptoms that are so worrisome. Although it makes you crazy with worry not knowing what is going on, the normal labs are actually a good sign. Alot depends on where the white matter lesions are and how did they elucidate if the second MRI actually had new lesions? The worrisome finding is the corpus callosum areas. If these are indeed demyelinating areas then there are actually few things that can do it, MS, a rare disease in italian men who drink red wine (doesn't sound like you), glioblastoma (although no well known we have seen several cases-but this is not you as you would be already diagnosed), oligodendroglioma (again this would be more definitive on MRI) and lymphoma (again not you). Now, one needs to know who read the film-as sometimes things are mistakenly called. Hypertension can cause small vascular events and these can give spots on the MRI. This we know you have, so some of the MRI changes might be do to this. However, the corpus callosum changes signal MS as very high on the diagnosis list. If true, then MS is on the top of the list. I truely hope that the corpus lesion is artifact or a misreading and the changes are due to hypertension. Hang in there.
Sincerely,
CCF Neuro MD