Brain MRI states "most consistant with chronic microvascular disease." (?)

[Symptomaniac]

Hello.  I recently had an MRI with & without contrast to see if there were pituatory issues that would explain why - as my doctor describes it, "my hormones are in the toilet."  My thyroid isn't reacting as though it is getting the message from my brain & even after this MRI the endo doctor said he could not understand why.  In the report it stated there were no identifiable pituatary lesions, so still no relief on the hormone issues....  But it did state .."No intracranial edema or mass effect is seen.  There are several small punctate foci of increased signal on flair and T2-weighted imaging in the subcortical white matter more apparent in the frontal lobes and parietel lobes.  This is most consistent with chronic microvascular disease.  No demyelinating changes are seen.  Posterior fossa and brainstem are unremarkable.  No abnormally enhancing intracranial lesions are noted.  The circle of Willis appears unremarkable.  Visualized sinuses are clear."  

I don't have diabetes or MS.  I was hit by a car when I was 4 & ran into the metal part of a glass door when I was 5 being knocked out both times, but don't remember any ongoing follow up due to either one.  I do have spinal issues - recently had fusions done the middle of my back down to my tail bone to correct Scoliosis.  I also have spinal issues in my neck, the spine is narrowing & it no longer has the natural curve.  It's straight, and at some point will also have to be corrected.  I have a history of migraines and "other" headaches that cause a great deal of pain, but are different than a migraine.  At times just laying my head down causes pain in my head & more often felt in the right side than the left.  Sometimes I can hear and feel my heart pulsing in my ear, and occasionally I hear the swishing sound along with it.  I occasionally have unexplained weakness in my arms & legs.  Recently I went to the ER because my BP went way up and I felt light headed and very weak.  My BP would come down & then it would shoot back up again.  The doctor at the ER did an EKG which was normal & explained it by saying I had a stomach virus.  I was very discouraged with his lack of desire to find out the cause of my condition.  It took about three days before I felt my strength come back.  I don't know if that's related to the findings in the MRI, but I wanted to give some history.  I've had ongoing bouts of weakness, jelly legs, headaches, double vision, high blood pressure, consistantly low body tempurature - normal for me is 97.6 or lower at times.  My blood work was good except my calcium was high10.5 on a scale of 6.6 - 10.2 mg/dl being the normal range & glucose was low with 65-99 mg/dl being the normal range.

Any direction or explanation you could offer would be appreciated.  I don't know what type of specialist I should follow up with on this.  The endocrynologist just said I needed to see another doctor about the findings.  Should I feel any sense of urgency to follow up?  What does this type of finding indicate?

Thank you for your time and consideration.
LTA

[rumpled]

Trauma can cause damage to the pituitary - find a neuro-endocrinologist. That is a separate issue from the calcium. Find a pituitary center.

[Dr. Kokil Mathur]

Hi
Welcome to the MedHelp forum!
High blood calcium levels are usually due to parathyroid gland problems. Again this comes under the preview of an endocrinologist, and if this one cannot help, take a second opinion.
High calcium can also be due to cancers like multiple myeloma, breast, lung and headand neck cancer.
Sarcoidosis, excess vitamin D fortified diet, certain high blood pressure drugs (if you are on any, please get this issue checked), or taking too many antacid gels can also increase calcium levels.
You need to discuss all these possibilities with your doctor. Take care!

[LivingInHope]

First of, I'm concerned about the fact you in your heading you say "brain MRI".  To properly look at the pituitary gland, they need to do a specially dedicated pituitary dynamic MRI, with and without contrast.  This type of MRI is done differently than a general brain MRI.  So, did you get the proper kind of MRI to look at your pituitary specifically?

Next, the radiologist feels you have microvascular ischemia, which means the tiny parts of blood vessels in your head are not getting enough oxygen, and this can result in tissue death.  Migraine can be linked with microvascular ischemia, as can high blood pressure.  Since you say you have bouts of high blood pressure and headache also, has anyone ruled out a rare tumor called pheochromocytoma with a plasma free metanephrines test?  Since you have bouts of high blood pressure, are you on any blood pressure medication?    

You say your calcium was high- had you taken any calcium within a few hours of getting that test done?  Did you get the test repeated to see if it is remaining high?  If so, did the endocrinologist check your parathyroid hormone to see if that is out of whack?  

What is your TSH level at?  You probably know one of the symptoms of hypothyroidism can be low body temperature- does the endocrinologist feel you have hypothyroidism?

Regarding the unexplained weakness in your arms and legs- did you ever get a potassium level checked during one of these episodes?  Regarding your low blood sugar, did the endocrinologist refuse to treat your for hypoglycemia?