What do you think about the answers to your questions?
Ok for the answers to your questions. I'm copying your questions to make it easier to answer them
"Did he place you on stoke preventative therapy or just let it stand that he thought you were having strokes? Do you have diabetes, chronic hypertension that is poorly controlled? did he work you up for a clotting disorder? "
he didn't put me on any preventative therapy. I do NOT have diabetes, Uncontrollerd Hypertension. He did not do any work up for a clotting disorder.
I did leve of the mention of the previous MRI (that there was one for comparision) it was listed at the end of the "TECHNIQUE" section. I just didn't bother copying that part as it was the only mention in the report.
I know he is like your first Neuro as he was the one that stated that I couldn't have MS because I wasn't a 35 y.o. female.
The second MRI was done on the same machine as the first one,but I have no idea of what stregth it was.
I was thinking that since the earlier intensities were not mentioned at all that maybe they were the "Chronic plaque formation" that they referred to.
One other thing that bothered me is that N1 said the storkes were in my vision center but the intensities were all over my brain. I'm not even sure if any of them were located in the vision center.
BTW every thing I do is a real pain. I live way out in the country. To get to my new Neuro it is a 2.5 hour drive.
Dennis
Ooops, I don't understand the mention of "chronic plaque formation." What plaques? Where are they decribed? The word plaque makes you think of MS plaques, but I have never heard of they being described as chronic. Still mystified.
Q
lol. What a pain!
Well, though I agree with you that N1 is an idiot, I have to let him off the hook for a couple things here. The first is that the MRI way OVERcalls sinus disease. We are all taught to ignore references to sinus infections on an MRI. The MRI is so sensitive to sinus inflammation that it will pick up residual inflammation from many months before. If there are problems in the patient that might be referable to the sinuses, then a CT is ordered.
When the reason for the MRI is put down the doc has to put his leading "suspicion." He suspected TIA, so that is put as the diagnosis.
Now, onto the meat of it.
18 hyperintensities is a lot, but, you (and I) are of an age when lazy doctors are inclined to dismiss all hyperintensities as "age-related." They do this, even though the studies that show many of us have these intensities, but when we do they are without symptoms. Since you were symptomatic he assumed the symptoms were from repeated strokes. Did he place you on stoke preventative therapy or just let it stand that he thought you were having strokes? Do you have diabetes, chronic hypertension that is poorly controlled? did he work you up for a clotting disorder?
I wouldn't be surprised if he was like my first highly esteemed neuro who believed that MS does not occur after age 50, so anything that does show up on the MRI has to be vascular (stroke) related.
I agree that the neuro's interpretation of "3 strokes" seems weird and without basis.
I have a real problem with the readings of your 2007 MRI. The discussion mentions that there are no "enhancing" areas. Okay, that means there are no active inflammatory areas that lit up with Gad (contrast). But, the interpretation does not mention at all whether there are any bright or hyperintense lesions. These are different from "enhancing lesions." Given that the MRI a year earlier showed so many this should have been a focus of the radiologist's readout. Since the issue isn't brought up at all we don't know whether those earlier hyperintensities disappeared or whether he just forgot (??) to mention them. Is what you printed the only "findings" on the report?
Were the two MRIs done on the same machine?? If not, was the strength different? I can't imagine that all of them simply disappeared. I am mystified that the earlier 2006 MRI was not mentioned and no mention is made of any lesions.
I think your new neurologist should read these and also have them officially re-read by a different neuroradiologist.
Does all of this make sense? I'm sorry you had the long drive to rectify a mistake. Sheeesh!!
Quix