Help with MRI results

[JT54]

H,
I had a recent MRI & my doctor has sent me to a neurologist. My doctor was very vague and I am trying to find help in the MRI results in layman's terms.

This is what it says

Scattered foci of periventricular and subcortical white matter signal changes in the frontal regions

Differential would include demyelinating process, small vessel, ischemia, vasculitis or migraine among others.

[sllowe]

Hi JT,

Welcome to the forum.  Why did the Dr. order an MRI?

Is what you posted here all the language in the report? It sounds like it's the interpretation.

The scattered foci are spots that are seen and then the radiologist listed some possible causes. With MS scattered foci and lesions are found in the brain and spinal cord and they sometimes (but not always) follow patterns consistent with what is typically seen from multiple sclerosis (scars).

Sorry to not be able to tell you what yours means, but I can point you to our health pages where you will find how MRIs show lesions in MS. Though all the above listed in your report can cause these changes too.

Do you have the appt. lined up with the neuro?

Thank you for joining us,
-shell

[JT54]

Hi,

Thanks for the response. The first part was the language of the report the second part was the interpretation.

The doctor sent me for a MRI for the following complaints, bouts of extreme fatigue, tingling in foot, dizziness or vertigo, weakness in legs and headaches on waking up.

I will be making an appt. with the neuro tomorrow.

Thanks JT54

[Quixotic1]

I agree with Shell's answer, but will explain a little further.

Scatter "foci" are scattered "spots".

Foci is the plural of "focus" - a single location

Periventricular means alongside the ventricles and this is a typical spot of MS lesions.  

Subcortical means in the white matter just below the gray matter cortex.  This is also a common spot for MS, but is also a common spot for the lesions of small vessel vascular disease like high blood pressure or diabetes.

As for explaining what these spots might represent, the radiologist typically lists the possible causes in the order that they are likely - though this is not a rule and it may be that all things are of equal likelihood.

Demyelinating process in general means MS, because it is far and away the most common demyelinating disorder.

Small vessel ischemic disease refers to high blood pressure, diabetes, etc

migraine - migraine

vasculitis - is the process where the body attacks the blood vessel with antibodies liek would be seen in lupus, Sjogren's Syndrome, and other autoimmune diseases.

Your symptoms are suggestive of a neurologic disorder, including MS, but they are nonspecific.  In order to determine if MS was likely, the neuro will want to know about these "bouts" of symptoms:  How many you have had, how long they have lasted, what symptoms have shown up with each bout.

Then the neuro needs to do a thorough, head to toe, neuro exam.  This will be looking for abnormalities on the exam that would correspond to areas of damage in the central nervous system.  Examples would be tests of balance and coordination, deep tendon reflexes, sensation, comparing one side to the other, eye movements.

If the history and physical are suggestive then you will get a whole battery of tests to rule out the "Mimics of MS."  If these are negative then he will look at whether the information from the history and physical are sufficient to make the diagnosis of MS - and he will use the info of the MRI to add to this information.

(S)he will also likely order an MRI of the spinal cord as some of your symptoms are suggestive of a spinal cord problem.

So, you are right to be requesting a referral to a neuro asap.

Hope this helps.

Quix