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Neurology (Expert Forum)
Inflamed optic nerve
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Inflamed optic nerve
by cole1, Apr 12, 2006 12:00AM
I went to see an opthamologist for an eye exam on Monday. I am a 40 year old female in good health, BP has always been good, 5'3", 125 lbs with one daughter. My peripheral vision in my right eye was a little blurry and I just assumed I needed reading glasses since everyone else in my family wears glasses.No headaches, pain, numbness or illness. I was using the Ortho Evra Patch which my doctor told me stop immediately as their trying to get it pulled off the market. Dr. said I had an inflammed optic nerve and sent me for an MRI. The MRI came back: Gyral pattern of abnormal signal involving the posteromedial aspect of the left occipital lobe even on the precontrast study. On the postcontrast study did not see any significan enhancement. Abnormal signal on both T2 and FLAIR images and appears only mildly bright on the diffusion. Felt to be consistend with a subacute infarction which may have exp. a subacute bleed. Some foci of abnormal signal in the periventricular white matter, largest being next to the body of the right lateral ventricl. Another one is superior to the posterior body of the right lateral ventricle and some vague foci bilaterally. None enhance after contrast injection. They are non specific. Diff. diagnosis would include ischemic change, demyelination,vasculitis. Findings most consistent with an area of subacute infaction in the left posteromedial occipital with evidence of subacute blled. Bilateral periventricular white matter foci of uncertain clinical significance.
What the heck does this mean? I went for reading glasses!!
What the heck does this mean? I went for reading glasses!!
Doctor's Answer
by CCF-Neuro-M.D.-PW, Apr 17, 2006 12:00AM
Its difficult for me to accuratley give you information without seeing the MRI images myself - so this information is not specific for your case.
However, if the report is correct, then it sounds like you may have had a 'silent' stroke. Stroke is when there is a lack of blood or oxygen supply to a part of the brain for whatever reason - arterial blockage, a clot etc, and htat part of the brain dies. But if that part of the brain doesn't do much, then you might not notice, and it only comes to attetion when you get a scan for something else!
A stroke in the left occipital region could cause some visual loss in the right field of vision, and the visual feild test should have been done by the ophthalmologist could tell this. THe gyral pattern means that it involves the grey matter of the brain which is atypical for something like MS. However inflamed optic nerves and white matter lesions around the ventricle are - more testing for MS may need to be done to fully exclude.
You should see a neurologist, perhaps one specializing stroke, who can evalaute the scan and try to make a diagnosis. While you may not have the 'usual' risk factors - age, BP etc, there are risk factors that can affect the young for stroke - ie blood clotting, artery tears or narrowings, PFO among some others.
Goodluck
However, if the report is correct, then it sounds like you may have had a 'silent' stroke. Stroke is when there is a lack of blood or oxygen supply to a part of the brain for whatever reason - arterial blockage, a clot etc, and htat part of the brain dies. But if that part of the brain doesn't do much, then you might not notice, and it only comes to attetion when you get a scan for something else!
A stroke in the left occipital region could cause some visual loss in the right field of vision, and the visual feild test should have been done by the ophthalmologist could tell this. THe gyral pattern means that it involves the grey matter of the brain which is atypical for something like MS. However inflamed optic nerves and white matter lesions around the ventricle are - more testing for MS may need to be done to fully exclude.
You should see a neurologist, perhaps one specializing stroke, who can evalaute the scan and try to make a diagnosis. While you may not have the 'usual' risk factors - age, BP etc, there are risk factors that can affect the young for stroke - ie blood clotting, artery tears or narrowings, PFO among some others.
Goodluck
Member Comments (3)
by cole1, Apr 12, 2006 12:00AM
Also I forgot to include that I had pre-eclampsia when I was pregnant with my daughter. They induced me and I just remember the headaches. It actually felt like someone shot me point blank between the eyes. I thought I could hear my skull crack at one point. The doctor told me it was normal with women who had pre-elcampsia. The headache hurt more than the delivery. I was in extreme pain and then they finally gave me a pain killer of some sort. After the delivery I had a small seizure and was unconcious for about 5 minutes. I don't know if this would have any bearing on my MRI but thought I would add it.
by cole1, Apr 18, 2006 12:00AM
Thank you for your reply. I went to go see Dr. Isaac Silverman at Hartford Hospital Stroke Center yesterday. I did indeed have a stroke as I mentioned before. Now we're just trying to find out what brought it on. I went this morning for my blood work and I go Friday morning for an ECHO and MRA. He started me on Aggrenox twice a day and depending on what the tests reveal I'll stay on this. I didn't realize that the stroke affected the peripheral vision in both eyes so I'll have to be extra careful driving. He also thought that the "foci" that mentioned earlier were normal in a 40 year old person and that one of them was just spinal fluid that they thought was a foci. Thanks again.
