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Neurology (Expert Forum)
White matter on the brain
This forum is for questions and support regarding neurology issues such as: Alzheimer's Disease, ALS, Autism, Brain Cancer, Cerebral Palsy, Chronic Pain, Epilepsy, Fibromyalgia, Headaches, MS, Neuralgia, Neuropathy, Parkinson's Disease, RSD, Sleep Disorders, Stroke, Traumatic Brain Injury
White matter on the brain
by Pam, Oct 27, 1999 12:00AM
Hi, actually I have lot's of questions,but this is the main one.I suffer from a lot of things-vertigo,chronic pain through out my body,double vision,muscle weakness,to name a few.I've had 3 MRI'S of the brain,each 2 yrs. apart.All show white matter in area's of the brain.Had a lumbar puncture,MS was ruled out.I was told it's FMS.But, I can't get a clear answer about the spots on my brain.Why ar they there and will they affect me some how?I sure would appreciate any info. you can give me.Many Thanks
Doctor's Answer
by CCF Neuro[P] MD, RPS, Oct 27, 1999 12:00AM
Dear Pam:
I am not sure what you mean by white matter. White matter is normal, it is the myelin surround axons in the axonal tracts of the brain. There is a difference with white matter and hyperintensities on MRI scan. Probably you mean the latter. Sometimes the hyperintensities are part of the aging process and can be seen in even younger people (late twenties). They are usually of no consequence. We often see them routinely on MRI scans of people who are getting scans for reasons not necessarily to MS. If hyperintensities are in areas that we question about MS, such as the temporal horns or periventricular regions then they may be a harbinger of MS, IF the clinical symptoms fit. They have come to have the name of unidentified bright objects or UBOs if they are just a nonspecific finding.
I hope this helps.
Sincerely,
CCF Neuro MD
I am not sure what you mean by white matter. White matter is normal, it is the myelin surround axons in the axonal tracts of the brain. There is a difference with white matter and hyperintensities on MRI scan. Probably you mean the latter. Sometimes the hyperintensities are part of the aging process and can be seen in even younger people (late twenties). They are usually of no consequence. We often see them routinely on MRI scans of people who are getting scans for reasons not necessarily to MS. If hyperintensities are in areas that we question about MS, such as the temporal horns or periventricular regions then they may be a harbinger of MS, IF the clinical symptoms fit. They have come to have the name of unidentified bright objects or UBOs if they are just a nonspecific finding.
I hope this helps.
Sincerely,
CCF Neuro MD
It is difficult to tell you what they may be. I would say, the the most likely scenerio is that they are just a finding of no consequence. However, if you have high blood pressure, they might represent small infarct (unlikely as these are usually in the basal ganglion region. But based on what you give me, I would think that they are just UBOs (see your previous posting).
Sincerely,
CCF Neuro MD
It is difficult to tell you whether your stroke and migraine headaches after the birth of your first child are related. There are many reasons for stroke after birth and I am sure that these possibilities were investigated thoroughly at that time. There is a small percentage of people who have migraines who are more prone to stroke, and this might fit you. However, before making this conclusion, you need to be evaluated by a good neurologist. As far as ADHD and dyslexia, likely migraine is not an associated. The reasons for each are alittle different and the exact etiology is currently unknown. However, far more people have migraine than either of these two entities as addults and the cross-over or people having both or all three is very uncommon.
Sincerely,
CCF Neuro MD
I'm posting on behalf of my wife. Whe is 37 year old white female. We have two children age 3 1/2 and 1 1/2. Here is a cronology of events:
1. Two months ago, while recovering from a nasty flu, my wife was getting back onto our bed at night, and she missed the bed and hit her lower back and her head on our wood bed frame. She was knocked out for approximately 15 seconds. She has no memory of being knocked out. We did not know she had a concussion until several weeks went by and we discussed the events of that night. In mean time, we took our kids to a amusment park and my wife rode in a roller-coaster which jostled her around a lot. After the roller-coaster ride is when her symptoms started appearing.
2. About a month after the concussion, she started getting tingling and numbness in her left hand and left foot. Getting worried about her condition, she saw her GP. Her GP indicated that the symptoms may be a start of MS. Needless to say, my wife was frightened!
3. Had an MRI of the head done on 12/4/99. The results indicated that she had slight deterioration of the "white matters" on her right lumbor (sp?). Her GP said this could very well be an indication of MS and referred her to a Neurologist (the earliest appointment with the Neurologist we can get is almost a month away!). In mean time, my wife is so scared her symptoms are getting worse when she thinks about them.
4. Now the tingling and numbness is flip-flopping between her right side and her left side. However, the symptoms does not appear all of the time. Somedays, she does not have any of the symptoms all day long. Other times, it only lasts for couple of minutes or longer.
Sorry for being long winded. My questions to you are:
a. Can the concussion she suffered two months ago cause the symptoms she is currently having?
b. Can the deterioration of the "white matter" be normal? How can they say the "white matter" has deteriorated when there is no baseline to measure against?
c. If her diagnosis is MS (understanding that MS is a clinical diagnosis), is there anyway to determine the severity of MS?
The unknown is the worst affliction that we have now. Due to the uncertainty, both my wife and I are very very scared. Any information/advise on my wife's affliction will greatly help us.
Thank You so much for your service,
Skip Chang (Worried husband in Colorado Springs)
Sorry to hear about your wife's symptoms. I am not sure where the lesion you are indicating in the brain, "lumbor"? White matter changes do not have to be related to MS. Many other things including the ageing process can give us white matter changes. There are particular areas of the brain that are affected by MS, such as the periventricular white matter, corpus callosum, temporal lobes, etc. Post-traumatic head problems could give your wife these symptoms, but over the internet I can't tell. There is no way to determine whether MS will be malignant or the usual relapsing remitting type. Time will tell, I wish there was a way of diagnosing. There some hints such as concentric types of demyelination etc. but obviously your wife does not have this.
Be sure and take the brain films with you to the neurologist. Depending on where the lesions are, there may be a correlation with the numbness and tingling.
I would venture to say that it is unlikely that your wife has MS. If her MRI looked worrisome for MS, your GP would have acted immediately and did a spinal tap with other lab work. The fact that your wife lost consciousness for over 15 minutes suggest that she had a pretty bad concussion. Most likely, this is post traumatic damage and should resolve. But, go to the neurologist and make sure.
Sincerely,
CCF Neuro MD
After reading the responses from the doctors to the other posts, I have additional questions:
1. My wife's symptoms seems to get worsen when the weather gets cold. Does this bode well that it may NOT be MS? (I hope so)
2. My wife does not have any feeling of weakness, just tingling and some fatigue. Is this another data point indicating that it may NOT be MS?
3. What other situations can cause the slight deterioration of the "white matter"?
Thank you in advance for your advise,
Worried husband in Colorado Springs.
Follow up to the follow up.
Sorry for the redundant question. I guess my bookmarks were stale and did not get your answer before I posted my second set of questions.
Thanks again for your feedback.
LESS Worried husband in Colorado Springs
CCF Neuro MD
An MRI was done to the cervical spine and he was told there is evidence of multi-level spondylltic degenerative changes, degenerative end plate changes and degenerative marrow signal. The most prominent spondylltic change is noted at C6-7 in which there appears to be a disc osteophyte complex.
I cannot understand what this means. Any way I can have an english (and simplified) version of what is wrong with him?
Thank you!
Terri
It is difficult for me to tell you exactly what is going on as I have not seen the films. But, I am guessing that the white matter changes are age related. As we age and undergo the diseases of life and our lifestyle our brain