Aa
MRI REPORT-please read over and let me know what you think
MR BRAIN WITHOUT CONTRAST
TECHNIQUE: Using spin-echo sequence, multiple T1 and T2-weighted images were obtained in the sagittal and axial planes. FLAIR and diffusion sequences were done also in the sagittal and axial planes.
COMPARISON: Most recent exam done in December 2009.
FINDINGS: Examination reveals several slightly prominent lymph nodes in the superior aspect of both sides of the neck. Bones show no abnormalities. Ventrical system is normal. A few, stable, tiny hyperintense areas in the periventrucular white matter. NO other significant abnormalities are appreciated.
IMPRESSION:
1) No acute intracranial abnormalities are identified.
2) Few, stable, nonspecific, small hyperintense areas in the periventricular white matter, suspect enlarged perivascular spaces.
3) Enlarges lymph nodes are identified in both sides of the neck, present on previous exams, and also unchanged.
END OF IMPRESSION.
Now I have pain in my lower back and abdomen. It feels like somehing is squeezing me. Very painful.....to the point that I am almost in tears....
Ok-thank you bob. I'm getting very frustrated, which i see from reading here, is quite common :(. My neuro has been very thorough and listens well. I'll have to update my list of issues and take it with me.
Make sure you tell them about the shocks to your face. I have the same thing, and they were able to prescribe a medication that has helped quite a bit. It can also be evidence of another form of demyelination.
Bob
Bob
I am 33 years old. The shocks on my face hit out of no where. I cannot find any pattern to them or anything that sets them off.
They are in the same place everytime. It hits just outside of my right eye and down along my right cheek bone. It is excruciatingly painful!
They last up to 4 seconds or so. Initiallly it would be a quick 1-2 second zap. Now it's like 2-4 seconds and is a pulsing zap.
They come out of nowhere. Sometimes I am at work or getting ready to go to bed. The worst was one day at work I had 8-10 shocks over the couse of 6 hours. This was a Thursday. The next day was when the dizziness started and was by far the worst dizziness I have ever had. It lasted from the time I got up, 6:00 am, till around 6:30-7:00 pm.
They are in the same place everytime. It hits just outside of my right eye and down along my right cheek bone. It is excruciatingly painful!
They last up to 4 seconds or so. Initiallly it would be a quick 1-2 second zap. Now it's like 2-4 seconds and is a pulsing zap.
They come out of nowhere. Sometimes I am at work or getting ready to go to bed. The worst was one day at work I had 8-10 shocks over the couse of 6 hours. This was a Thursday. The next day was when the dizziness started and was by far the worst dizziness I have ever had. It lasted from the time I got up, 6:00 am, till around 6:30-7:00 pm.
Okay, I went back and reread all of your posts.
The MRIs really aren't very helpful. There are at least 3 tiny foci in areas that could be all sorts of things - including MS. And Migraine disease is a major cause. Most neuros don't like to count lesions that are less than 3mm (this is larger than punctate). But the truth is, that lesions can vary from invisible to very large and every size in between.
I am very interested in the shocks of pain to your face. Where do these occur? Are they always on the same side? the same place? How often do they occur? Is there any particular thing or things that trigger the pain? How severe is the pain?
Remind me how old you are.
We need to discuss this facial pain. This is a very different kind of problem and may give us more of a direction to look in.
Quix
The MRIs really aren't very helpful. There are at least 3 tiny foci in areas that could be all sorts of things - including MS. And Migraine disease is a major cause. Most neuros don't like to count lesions that are less than 3mm (this is larger than punctate). But the truth is, that lesions can vary from invisible to very large and every size in between.
I am very interested in the shocks of pain to your face. Where do these occur? Are they always on the same side? the same place? How often do they occur? Is there any particular thing or things that trigger the pain? How severe is the pain?
Remind me how old you are.
We need to discuss this facial pain. This is a very different kind of problem and may give us more of a direction to look in.
Quix
Lesions can be caused by other things than MS. Sometimes the location of the lesions give a really good clue as to whether it's MS. I had lesions around the corpus collasum which is a big piece of why I was diagnosed.
See a great web site that tells more about MS lesions versus vascular:
http://www.radiologyassistant.nl/en/4556dea65db62
There are several diseases that can cause lesions by MS. Stroke, cancer, stroke, aneurysm, central nervous system lupus, Devic's, Sjogren's, vasculitis, Lyme disease, infections, and even migraine. This list is not complete--the only ones that are at the top of my head from what I've learned on this site. The size and shape of the lesions rules in and out certain problems and diseases.
Lesions are always abnormal, but doctors do say that lesions develop with age. However, this is very uncomforting to be told that the lesions found on your MRI are completely normal when you're having lots of problems. Plus, some doctors don't agree with this. I also have heard that cigarette smoking can cause them--this is also a touchy subject.
You may want to poke around on the Health Pages above. There's lots of good information there.
See a great web site that tells more about MS lesions versus vascular:
http://www.radiologyassistant.nl/en/4556dea65db62
There are several diseases that can cause lesions by MS. Stroke, cancer, stroke, aneurysm, central nervous system lupus, Devic's, Sjogren's, vasculitis, Lyme disease, infections, and even migraine. This list is not complete--the only ones that are at the top of my head from what I've learned on this site. The size and shape of the lesions rules in and out certain problems and diseases.
Lesions are always abnormal, but doctors do say that lesions develop with age. However, this is very uncomforting to be told that the lesions found on your MRI are completely normal when you're having lots of problems. Plus, some doctors don't agree with this. I also have heard that cigarette smoking can cause them--this is also a touchy subject.
You may want to poke around on the Health Pages above. There's lots of good information there.
But lesions can be caused by things other than MS? Are they always an indication of a problem?
When a radiologist says hyperintense, what he/she means is that it's an area of increased signal. Radiologists are notoriously vague about some things, because their role is to interpret the findings, not to diagnose.
But yes, it usually means that it's a lesion.
But yes, it usually means that it's a lesion.
hyperintense areas in the periventrucular white matter-is this the same thing as a lesion, something else or unknown?
Looks like your small punctate hyperintense foci in the frontal lobe have disappeared - which is a good thing. However the "Minimal hyperintense signal is present in the left frontal periventrical region" is still there.
I have/had lots of cognitive and memory problems, but my first MRI didn't show any lesions in those spots. So my neurologist didn't believe me! Which is crazy. If a patient is telling you that they're having problems, don't blow it off. It's a mistake to look at the MRI for your neurological problems. An MRI will spot some problems, and miss others.
This is why I always recommend the best MRI you can find. 3T is the best widely available MRI, and it'll catch things that the others won't. I don't know what strength this MRI is at.
And I was diagnosed based on the results of a 1.5T MRI, plus spinal tap and history of symptoms. So you're not doomed if your MRI wasn't a 3T - it just won't be the full story.
So I went to the neurologist a couple of years ago, because I was having a really hard time thinking clearly. Always forgetting stuff, wasn't able to follow a simple recipe, wasn't able to work efficiently... I asked for something called a neuro-psychological examination. I told him it was for baseline, so I could see future cognitive decline. Of course that was a load of horse pookey. I already knew I was having cognitive problems, but he wasn't going to acknowledge it.
The neuro-psych took 8 hours, and was a pretty intense test. Some stuff I just wasn't able to do. When I was done my test results showed that I had lost 30 IQ points. Essentially I was (and am) suffering from mild cognitive impairment. The psychologist recommended Aricept, and after arguing with my neurologist, I got a couple of samples and a prescription.
The good news is that it worked! Whether it was a crutch to help me until my brain healed up, or whether it helped me find new pathways, I don't know. But I was on Aricept for five months, and then stopped because I felt that I had recovered much of my thinking.
So if your neurologist is holding back on treating your symptoms until they find a cause, you need to address that with him/her. Fatigue and mental alertness can be controlled with medication.
I have/had lots of cognitive and memory problems, but my first MRI didn't show any lesions in those spots. So my neurologist didn't believe me! Which is crazy. If a patient is telling you that they're having problems, don't blow it off. It's a mistake to look at the MRI for your neurological problems. An MRI will spot some problems, and miss others.
This is why I always recommend the best MRI you can find. 3T is the best widely available MRI, and it'll catch things that the others won't. I don't know what strength this MRI is at.
And I was diagnosed based on the results of a 1.5T MRI, plus spinal tap and history of symptoms. So you're not doomed if your MRI wasn't a 3T - it just won't be the full story.
So I went to the neurologist a couple of years ago, because I was having a really hard time thinking clearly. Always forgetting stuff, wasn't able to follow a simple recipe, wasn't able to work efficiently... I asked for something called a neuro-psychological examination. I told him it was for baseline, so I could see future cognitive decline. Of course that was a load of horse pookey. I already knew I was having cognitive problems, but he wasn't going to acknowledge it.
The neuro-psych took 8 hours, and was a pretty intense test. Some stuff I just wasn't able to do. When I was done my test results showed that I had lost 30 IQ points. Essentially I was (and am) suffering from mild cognitive impairment. The psychologist recommended Aricept, and after arguing with my neurologist, I got a couple of samples and a prescription.
The good news is that it worked! Whether it was a crutch to help me until my brain healed up, or whether it helped me find new pathways, I don't know. But I was on Aricept for five months, and then stopped because I felt that I had recovered much of my thinking.
So if your neurologist is holding back on treating your symptoms until they find a cause, you need to address that with him/her. Fatigue and mental alertness can be controlled with medication.
This is my 2006 MRI report:
2006 MRI-i found the report. I had the psuedotumor issue checked out and the neuro felt that is was a mistake altogether and confirmed with the radiologist. Can someone interpret the rest???
The right lateral ventricle is slightly smaller than the left. This appears to be a normal variant and appears unchanged since the prior exam. Overall lateral and 3rd ventricle sizes are also borderline small, and unchanged since the prior exam. The T2-weighted scans show small punctate hyperintense foci in the frontal what matter bilaterally, at least one on the left and two on the right. These do not appear significantly changed since the prior exam. Minimal hyperintense signal is present in the left frontal periventrical region, possible slightly also surrounding a subependymal vein. This also appears stable since the prior exm. Diffusion-weighted scans show no acute abnormality. Basal intracranial arteries appear grossly patent.
T2-weighted scans show focally increased signal within a few mastoid air cells on the right side. This internal auditory canals are normal in size.
IMPRESSION:
1. few tiny foci of signal abnormality in the frontal white matter, stable since the prior exam. These are nonspecific and of uncertain if any significance. These could represent migrain related lesions.
2. relatively small lateral and third ventricles. This may be a normal variation. The possibility of a psuedotumor cerebri should be considered. Please correlate with clinical findings and fundal examiniation.
3. minimal mucosal inflammation disease in the right mastoid.
Quix read it earlier this year and felt it was ok. I can't tell if there have been changes or not.
2006 MRI-i found the report. I had the psuedotumor issue checked out and the neuro felt that is was a mistake altogether and confirmed with the radiologist. Can someone interpret the rest???
The right lateral ventricle is slightly smaller than the left. This appears to be a normal variant and appears unchanged since the prior exam. Overall lateral and 3rd ventricle sizes are also borderline small, and unchanged since the prior exam. The T2-weighted scans show small punctate hyperintense foci in the frontal what matter bilaterally, at least one on the left and two on the right. These do not appear significantly changed since the prior exam. Minimal hyperintense signal is present in the left frontal periventrical region, possible slightly also surrounding a subependymal vein. This also appears stable since the prior exm. Diffusion-weighted scans show no acute abnormality. Basal intracranial arteries appear grossly patent.
T2-weighted scans show focally increased signal within a few mastoid air cells on the right side. This internal auditory canals are normal in size.
IMPRESSION:
1. few tiny foci of signal abnormality in the frontal white matter, stable since the prior exam. These are nonspecific and of uncertain if any significance. These could represent migrain related lesions.
2. relatively small lateral and third ventricles. This may be a normal variation. The possibility of a psuedotumor cerebri should be considered. Please correlate with clinical findings and fundal examiniation.
3. minimal mucosal inflammation disease in the right mastoid.
Quix read it earlier this year and felt it was ok. I can't tell if there have been changes or not.
Would this account for why I am having issues at work and my complete inability to make decisions about anything-even what's for dinner?
The only thing to look at is the "Few, stable, nonspecific, small hyperintense areas in the periventricular white matter, suspect enlarged perivascular spaces." This by itself is not enough for a diagnosis.
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