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regarding MRI report
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regarding MRI report

hye i am Mohan 28 years old ,i had undergone MRI scan as directed by doctor which says
"T2 and FLAIR hyperintensities seen in bilateral fronto parietal white matter more prominent on the left side.Mass effect noted effacing the adjacent cortical sulci.Multiple Punctate T1 hyper and T2 hypointense signals are noted within the white matter hyperintensity in left parietal lobe"

and it concludes saying
"MULTIPLE PUNCTAUTE HEMORRAGES IN BILATERAL CEREBRAL HEMISPHERE MORE PROMINENT IN BILATREAL FRONTO PARIETAL  LOBE WITH WHITE MATTER OEDEMA PSSSIBILITY OF ANGIOPATHY TO BE CONISIDERED"

please explain me can this can be cured ?
effects of this in the future?i am very much worried.....

thanks,
regards
mohan
bangalore

2 Comments Post a Comment
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Avatar_dr_f_tn
Hello,
I can confirm the exact cause of your condition only after knowing your complete medical history, clinical examination and correlation of the test results. These findings on the MRI can be seen in any infection, inflammation or malignancy involving the central nervous system. White matter odema is seen in primary demyelinating disorders, infectious, neoplastic, post-traumatic and metabolic disorders .Angiopathy could be seen in leucoencephalopathy, stroke, hypertension or collagen vascular diseases like SLE etc.A clinical correlation of MRI findings is very important. Write to me again with more details.
Best wishes and regards!
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Avatar_n_tn
Thanks a lot for your response. I am pleased .Thank you medhelp and thank you Arti madam.
Here is medical history in detail,
  I am an Engineer by profession ,28 years ,it started when i was in studying  my 2nd year Engg.Once i fell unconscious in class room and i was ok after an half an hour.I took some rest and back to business next day. symptoms are like numbness in left hand, speaking difficulty,tiredness,loss of energy, right sided headache.CT scan was done,which was normal .Doctor prescribed me Divalapro tablets which he insisted me to take regularly.I took for some time,to be frank i was irregular, even i stopped it.
Like this it happened twice/thrice in 4 years (In this period I was in peak of stress due to job search  ). Due to lack of sleep, stress.
In 2010 ,i got one seizure, where i had Numbness in left hand, difficulty in speaking which lasted for some time. My MRI findings has shown findings as:
"T2 and FLAIR hyper intensities are seen in bilateral fronto parietal  white matter more prominent on left side. Mass effect noted effacing the adjacent cortical sulci.Multiple punctuate T1 hyper and T2 hypo intense signals are noted within the white matter hyper intensity in left parietal lobe."

Conclusion: MULTIPLE PUNCTUATE HEMMORRAHAGES  IN BILATERAL CEREBRAL HEMISPHERE MORE PROMINENT IN BILATERAL FRONTO-PARIETAL LOBE WITH WHITE MATTER OEDEMA POSSIBILITY OF ANGIOPATHY TO BE CONSIDERED.
After this I undergone course of  Tab. Epilex chrono. .
In the mean time I was again irregular.
After nearly one year(01/2011) I got another seizure which doctor recorded like this before admitting,”Patient has 1 episode of weakness of weakness of Lt.UL associated with numbness of Lt.UL since one day which lasted for  5-7 mins improved completely after mild headache”.
Discharge report says ,MRI brain plain & contrast showed  cortical grey matter and sub Cortical white matter T2 and FLAIR multiple hyperintense lesions,non enhancing suggestive of ? vasculitis.MR angio neck+brain showed Rt,vertebral hypoplastic. Rt A1 Segment not visualized.EEG and ECHO was normal.TSH<0.001,anti tpo was<10,TC thyroid scan suggestive of inflammation. Patient was treated with IV methylprednisolene,antibiotics Tab inderal,tab sibelium,Tab clopilet,Tab Epilex chrono was stopped,adviced to go genetic studies to rule ou MELAS and hemiplegic migraine.

After this i did my MELAS test which was normal and undergone  "CT ANGIOGRAM OF CIRCLE OF WILLIS AND NECK VESSELS" Impression as ”NORMAL CT ANGIOGRAM OF THE CIRCLE OF WILLIS AND THE NECK VESSELS.and also did “CT SCAN BRAIN PLAIN AND CONTRAST “as suggested by doctor. Impression as “NON ENHANCING LEFT PARIETO OCCIPTAL HYPOATTENUATION.possibilities are vasculitis/foci of demylelination.

Medication continued with same as above mentioned Tablets this  Tab Predmet included.

In this period I was feeling like I had viral fever for months, sleepy always. Though doctor told its an side effect and varied dosage and same course continued.

The last seizure I got after 8 months (08/2011) and it was severe as compared to other .i was unconscious for almost 12 hours. I was hospitalized again, which is recorded as cluster of Right focal seizure Rt hemi paresis right hemorrhagic infa  ? vasculitis.

I had MRI,which findings and conclusion was,
"T2 and FLAIR hyper intensities are seen in bilateral fronto parietal  white matter more prominent on left side. Mass effect noted effacing the adjacent cortical sulci.Multiple punctuate T1 hyper and T2 hypo intense signals are noted within the white matter hyper intensity in left parietal lobe."

Conclusion: MULTIPLE PUNCTUATE HEMMORRAHAGES  IN BILATERAL CEREBRAL HEMISPHERE MORE PROMINENT IN BILATERAL FRONTO-PARIETAL LOBE WITH WHITE MATTER OEDEMA POSSIBILITY OF ANGIOPATHY TO BE CONSIDERED.

Tab course is Tab M-toin, Tab clopilet,Tab sibelium,Tab Predmet .
In this course doctor suggested me to undergo Biopsy,after some time he declined it.
Stopped Tab predmet,continued with others though.

I went to the other neurologist for opinion by showing him all the scans/reports, his conclusion is it is a irritation of blood vessels which triggers the seizure.He suggested me Biopsy.(but he wants to confirm it again by MRI brain plain+contrast)

Last seizure I got in 01/2013 ,which had same symptoms like numbness, unconscious and I also fell the floor, my mouth twisted,it lasted for 20 mins.Doctor suggested phenytoin level which showed increase in toxicity .and he changed the dosage and stopped Tab Sibelium.

Now I am taking Tab M toin ,Tab clopilet.

I want to know your opinion and feedback. Can I marry ?

Thanking you,


Regards,
Mohan
Bangalore.






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