Brain MRI results

Hello to all,
I am 53 yrs young and am 15 years post pituatary tumor removal with radiation.  I have acromegaly from tumor.  On followup brain MRI, it showed flow voids within both carotid ateries.  What does exactly mean and is this something I should see a vascular specialist for? I have a family history of heart disease and High cholestrol which I do have.

My second question is regarding the brain. The MRI results state-"...there are stable foci of increased T2 signal within the subcortical and periventricular white matter tracts bilaterally.  These are nonspecific changes that could be realated to the sequel of chronic microvascular ischemia."  Can someone translate that for me?

I don't see the endocrinologist until next month and I need to have some information now.
Thanks for your help!  
Tags: brain mri.

[Daniel M Prevedello, MD]

Dear BizzyLizzy2

Twopack did a great job answering your question.
Flow voids from the carotid are normal findings and the changes in the white matter are very common and not necessarily represent disease.

Thank you for you help Twopack

[twopack]

I followed you over here from the MS forum BizzyLizzy and I'm glad I did since it doesn't look like there is much activity here.  I'm no expert but I can tell you a thing or two about what your MRI report says to me.

First, flow voids are NORMAL findings on MRI.  I know they sound terrible.  Nobody is looking for voids in their brain!  But it actually means there is no obstruction seen in the carotid arteries where the flow voids are.  That's a very good thing :)  Blood doesn't 'show' on MRI so there is a 'void' where blood is flowing.

I can't be sure about the small areas of increased T2 signal but the report does say they are "stable".  That leads me to think they have shown up on past MRI and haven't changed in size or appearance.  "Chronic microvascular ischemia" refers to tiny areas that have been damaged by lack of blood flow.  I have been told this is a common finding in people who have hypertension, escecially as we age.  It isn't necessarily something to worry about (remember, they are stable) but should be incentive to work on maintaining good control of your blood pressure - and blood sugar if that is a problem as well.

Basically, the radiologist says those areas are non-specific - they don't have the characteristic look of the kind of damage caused by any specific disease or problem with the brain.  He leaves further interpretation to the ordering physician since that is the doctor who knows you and your symptoms.

I hope this helps you get through your long wait to see the endocrinologist.  Feel free to come back through the MS forum if you have other questions.  We know more about MS than other stuff but do like to help all comers when we can.

[Bizzylizzy2]

Thank you very much for taking the time to explain this to me.  What worries me about the ischemia stuff is that I have never had hypertension or diabetes and other than the acromegaly, I am relatively healthy.  It just scares me that no one can tell me how the acromegaly will effect on body as I get older.  The doctors seem to pass things off to the next one so I'm trying not to fall in the cracks.
Thank you very much for your insight.  I will see what the endocrinologist has to say.
Have a great day!