Brain MRI impression...question

[lydia231]

I had a brain mri last week, the neuro said highly unlikely to be ms even though there were some white spots in my brain.  I asked for a copy of the imaging report and was hoping someone would be able to tell me what the doctor who read the mri means when he wrote his impression.  I will type it as he wrote it:

Impression:

Mild nonspecific, nonenhancing white matter signal abnormalities.  The differential diagnosis includes migraine headache, early microvascular ischemia with multiple sclerosis and vasculitis considered less likely.  Correlate clinically and consider 1-year follow-up mri.

I don't understand how he worded it.  Can anyone make sense of this for me.  Thanks again for all your support.

[lydia231]

Thanks again for your comments. Actually I was reading the report from the MRI where my neuro said I have six or seven lesions. I can't explain the symptoms I'm having, but it is looking less and less like it may be ms.  I go to the neuro today to find out about my results for the cervical spine mri.  I hope there are some answers.

[COBOB]

OK.  I went to your Oct 21st post and you had 6-7 lesions on a previous MRI.  On this MRI you are down to ONE.  That is not typical of migraine, ischemic disease  or vasculitis.  From what I have seen they just seem to get worse.  Now with MS, thing can heal.  The location of your current visible lesions "left frontal deep and subcortical white matter" is not typically going to demonstrate sensory or motor symptoms.  That area of the brain is "more associated with executive function." (apathy, disinhibition, etc)

Keep in mind, I'm not a doctor, so these are just "book facts."

Bob

[lydia231]

Thanks, here is what the doctor wrote in findings:

Brain pathology is normal with no evidence of Chiari I malformation.  There are no diffusion signal abnormalaties to suggest acute ischemia.

The lateral ventricles and basilar cisterns are normal in size and configuration.  No intracranial blood products are visible.

Mild asymmetric left frontal deep and subcortical white matter signal abnormalities are noted.  No callosal. pericallosal, brainstem or cerebellar lesions are visible.  There is no abnormal enhancement on postinfusion sequences.

The major arterial skull base flow voids are maintained.  The orbits are normal.  There is no fluid within paranasal sinuses.


I hope this makes sense. I don't believe I have ever had a migraine, though I have been getting headaches.

[RedFlame]

Hi Lydia,

The radiologist report is a fairly typical in it's wording and 'differential diagnosis' possibilities.  Those are all 'pat answers' the radiologist dictates.  Any neurologist worh his/her weight will be the person that studies the films and interprets them.  

Only 30% of people that are 60 years of age show signs of Ischemia--- and the probability decreases with each year dependent on your age.  

Does the possibility of 'Ischemia' or 'migraine' etc account for you current symptoms?  Do you have migraines?  You are looking for answers to what is happening to your body.

I don't know your symptoms etc., but I would push for further testing if you feel you are getting  There are other tests that can be done.  

You have to be your own advocate.

Hang in there!  Red

[COBOB]

The radiologist thinks it could be migraine or microvascular ischemic disease, but there is stall a possibility of MS or vasculitis.  The radiologist is suggesting that the neurologist match your clinical presentation to these possibilities.  It would be better to have the whole report, not just the impression.  The body of the report should list the regions of the brain where the lesions are located.

Bob