White spots and black holes on MRI

Question

I have epilepsy. I did MRI and I found white spots on this image. What's this?
http://img607.imageshack.us/i/25069127.png/

On some images I see multiple black holes - what they are means?

Meroque · Answer

Thank you for answer.

So if the white spots are propably a demyelination, so why my radiologist don't described it in on result? She don't described cavum septum pellucidum too.

I have these symptomps.

Everyday my right part of my hand and two fingers are numbness after awakening. Sometimes it stops for one or two weeks. Sometimes numbness starts when I enter in sleep. My spine never hurts.

Sometimes I have paresthesia - electricity on my body. 

Sometimes a lot of time I felt burning on left hand.

Two times I was very tired and gasped after walk. I think it was after 100 meters and suddenly I lost control of my legs for 4 seconds.

DrSharma · Answer

Hi there. Your MRI scan shows white punctate lesions suggestive of demyelination. You need to correlate these with the clinical findings, why was the MRI done in the first place etc. if this was done since there was a clinical suspicion of multiple sclerosis; these lesions have significance and may represent MS plaques. Diagnosis of MS is made based on clinical history of previous attacks, CSF examination, and MRI. Certain diagnostic criteria and radiological criteria need to be fulfilled. These while lesions represent micro vascular ischemic changes in the brain. So these changes are seen in people with micro vascular or macro vascular risk factors like history of hypertension, diabetes, high cholesterol etc. these could also mean infectious or inflammatory conditions. the black holes are the normal anatomy of brain viz. sulci and gyri. Sulci are a depression on the brain surface and surround the gyri. Larger sulci are called fissures and divide the brain into lobes. Consult your neurologist for best advice. Hope this helps. Take care.