Need Help Interpreting Information

[Dante220]

Here are my MRI results,
and a post i did in the neurology forum.

Any feedback would be appreciated. I am very upset, and I have an appointment with a nerologist tomorrow.

I had an MRI done. Experiencing Numbness in feet, and left ear ringing.

Here is some info from the MRI

TECHNIQUE: Routine brain, without and with IV gadolinium. Routine MRA of the circle of Willis. CONTRAST: 10 ml Magnevist. FINDINGS: There is a 1.5 cm zone of increased T2 signal intensity adjacent to the atrium of the right lateral ventricle. There are a few additional small foci of increased T2 signal intensity in the cerebral white matter, some of which have a periventricular location. There is a small focus adjacent to the frontal horn of the right lateral ventricle demonstrating mild contrast enhancement. The findings are most consistent with a demyelinating process, with an active focus of demyelination adjacent to the right frontal horn. There is no evidence for acute ischemia or intracranial hemorrhage. No mass lesions are identified. Thin section images through the internal auditory canals were not obtained. If desired, the patient could be brought back for further imaging at no additional cost. The paranasal sinuses are unremarkable. MRA OF THE CIRCLE OF WILLIS: There is no evidence for major vessel occlusion. There is no evidence for an aneurysm or vascular malformation. The circle of Willis is anomalous, with an absent right posterior communicating artery. IMPRESSION: 1. Multiple foci of increased T2 signal intensity in the cerebral white matter, with a large focus adjacent to the atrium of the right lateral ventricle. Small enhancing focus just superior to the frontal horn of the right lateral ventricle. The findings are most consistent with a demyelinating process such as multiple sclerosis, with a small active focus of demyelination in the right frontal lobe. Clinical and laboratory correlation is suggested. Other possibilities would include vasculitis. A less likely consideration is Lyme disease. 2. No evidence for acute ischemia or intracranial hemorrhage. No pathologic gadolinium enhancement identified. 3. Thin section images through the internal auditory canals were not obtained. If desired, the patient could be brought back for further imaging at no additional charge. 4. Absent right posterior communicating artery. Otherwise unremarkable MRA of the circle of Willis.


Could this be due to a pinched nerve.
I also have a history of depression, although it was a circumstance, and I have managed with excercised.
The "Comments" posted below are provided by individuals and reflect their personal opinions only. Under NO circumstances should you act on any advice or opinion posted in this forum.  ALWAYS check with your personal physician before taking any action regarding your health! Med Help International and our partners, sponsors and affiliates have no obligation to monitor any "Comments" posted on this site, or the content and/or accuracy of such exchanges. Med Help International does not endorse the views of any user.
LLWB

10/01/07
Dante No, this is not from a pinched nerve. It appears to be from a disease called multiple sclerosis. Please go to the patient to patient forum, and as Quix for help in interpeting these findings. She is a retired pediatritian who has MS and is very very knowledgable about this disease. Sorry for your seeming diagnosis. MS can also cause depression by physically injuring the nerves. Good luck and God Bless

[Dante220]

Thanks for you kind words, I am trying to have some grace and composure this morning.

You knowledge is appreciated. And I cannot believe you are online, I do not thing I would nrmally choose this option to talk to people.

[Quixotic1]

There is no reason to think you'll lose that.  The odds are in your favor.  Quix

[Dante220]

Thanks for taking the time to read and comment, I truly appreciate it.
I am having a tough time coping right now, and i have a son who I love dearly and I want to share a happy and active life with him and my husband.

[Quixotic1]

Thank you.  Your answers do not change any of my comments.  I'll be checking the computer all evening if you have any questions before seeing the neurologist tomorrow.  Otherwise, good luck.  We'll be hoping for a report.  MS (if that it what it is) may not affect your activity level for some time, or if it does, it may well be temporary.  Quix

[Dante220]

Here are some answers to your questions.
No history of MS or Auto Imune in my family.
My mom and maternal grandparents have digenerative disc disease.
37, married female, extremely active lifestyle and a 3yr old son.
No vision problems ever.
Tingling yes, but I believe I have carpel tunnel. I sit for my job. computers for 20 years.
I had a serious hospitalizing migrane about 2 years ago.
I run, climb, and bike. no drugs, no smoking. no severe head injuries.
I suffered a severe depression once, was treated and moved on with no other serious episodes - 10+ years ago.

In December I had strep - took pennicillin, had an allergic reaction, had vertigo for 2 months, and pink eye. IT was an awful time, the vertigo and the ear problem.

I do not have vertigo now.

[Dante220]

Here are some answers to your questions.
No history of MS or Auto Imune in my family.
My mom and maternal grandparents have digenerative disc disease.
37, married female, extremely active lifestyle and a 3yr old son.
No vision problems ever.
Tingling yes, but I believe I have carpel tunnel. I sit for my job. computers for 20 years.
I had a serious hospitalizing migrane about 2 years ago.
I run, climb, and bike. no drugs, no smoking. no severe head injuries.
I suffered a severe depression once, was treated and moved on with no other serious episodes - 10+ years ago.

In December I had strep - took pennicillin, had an allergic reaction, had vertigo for 2 months, and pink eye. IT was an awful time, the vertigo and the ear problem.

I do not have vertigo now.

[Quixotic1]

Hi, I'm sorry for the shock that these MRI results have given you.  Welcome to the forum.  I am a physician, but NOT a neurologist and I have MS.  We are a wonderful group here of people with MS, or probable MS and many others with undiagnosed neurological problems.  A quick answer to your question is:  No.  There is no possible way that a pinched nerve anywhere could cause thess findings in your brain.  The most likely diagnosis is, indeed, multiple sclerosis, but all the possibilities need to be checked out.  You do not have a brain tumor.

Your neurologist tomorrow needs to do a very comprehensive neurologic exam to see if there are any findings that are abnormal, like other areas of diminished sensation, reflexes, hearing, vision, muscle strength all over, balance and things like that.  He/She will ask you many questions.  Things to think about before you see him are:  Have there been any weird things recently or even in the distant past that you ignored or explained away...things like numbness, weird visual disturbances, odd, severe fatigue, tingling places that felt like they were "asleep", problems with your balance, muscles feeling week, problems when you get/got hot.

Do any members of your family have MS or autoimmune problems?

Your MRI results:  You have a lesion (a spot of abnormality which shows up as "brighter) in the brain which is about 3/4 of an inch in size.  There are a few more tiny spots (foci) of bright signal which are located close to the ventricles which are fluid-filled spaces in the brain (filled with CSF -cerebro-spinal fluid).  These spots would represent scarring.  There is one spot that "enhanced" when they injected the contrast, called Gadolinium.  This means that the spot is actively inflamed and is new.

The description of these spots is very characteristic of the way Multiple Sclerosis looks on an MRI.  MS tends to cause scattered areas where the myelin sheath around the nerves in the brain and the spinal cord is attacked, becomes inflamed, and then often scars.  

It is not unusual for the first symptoms of MS to be something like numbness or tingling in an area or problems with  balance.  The ringing in your ears is also common.

How old are you?  Are you male?  (only answer if you are comfortable)

The neurologist will very likely want to do an MRI of your spine (cervical and thoracic), if that hasn't been done.  He may also order a special test of your vision called a Visual Evoked Response, to see if there has ever been any inflammation of the optic nerve.  He may consider doing a spinal tap.  He may be able, depending on his expertise with MS be able to give you a "Possible MS" diagnosis, and discuss possibly starting therapy.  A lot depends on your history and what your exam looks like.  There will also likely be a number of blood tests to rule out other diseases that mimic MS, like Lyme Disease, strokes and autoimmune diseases like lupus.

We certainly cannot diagnose MS from here, but it sounds terrifying to most people.  It is NOT a terminal illness.  The majority of people have a slow progression of problems, but there are new meds to help slow it down.  The face you see of it on TV is not the norm.

I will be up and checking the computer until about 12:30 PST, so feel free to ask questions.  I'm sure this slapped you in the face and you have a jillion things in your head.  We have several dozen active members and several men, some diagnosed and some still trying to get a diagnosis of what is wrong.  We'll try to get you mentally and emotionally ready to see the neurologist.  Not all neurologists are skilled at diagnosing MS, so we can also help you interpret what goes on in the visit and what the plans or the things he tells you mean

Quix, MD

[JonM]

Welcome to the forum, I was diagnosed with MS about 10 months ago.  It is a very difficult time when we are first diagnosed.  You will grieve and this is normal.  You may want to take some Anti Depressants for a while until you adjust.

Believe it or not there is life and wonderful life after being diagnosed.  Brighter, much brighter and happier days are ahead.  Listen to your Nuero, and get on a regime of DMDs (disease modifying drug) ASAP.

Take Care!!
Jon