Brain MRI results

[raym13]

During a brain MRI taken without contrast to help treat my headaches, the radiologist's findings were, "there is a small focal nonspecific area of increased intensity within the right perifrontal horn likely representing a gliosis versus nerve epithelial cyst."  The Neurologist's impression was "a small nonspecific area of T2 high intensity within the periventricular white matter on the right."  

My neurologist has told me that this is "of no clinical significance" and is perfectly normal and nothing to worry about.  I'm hoping he is absolutely correct, but I would like to hear from someone else before I completely dismiss the findings.  

What is this in layman's terms?  Is it common among perfectly healthy people?  What could have caused it?  Should I undergo an expensive follow up MRI with contrast to investigate further?  Thank you very much.

[Sara Khan]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.

Without the ability to examine you and obtain a history, I can not tell you what the exact cause of your symptoms is. However I will try to provide you with some useful information.

The findings that you describe are VERY commonly seen on brain MRI's, and in the setting of a normal neurological exam, do not mean anything sinister. We often call these "UBO's" or "unidentified bright objects".

The ventricles are the fluid filled spaces in our brains. The white matter basically consists of nerve processes of our brain cells. It is "white" because of the myelin covering or fat around the nerves. The smallest of blood vessels supplies the area of the white matter immediately next to the ventricles or the "periventricular white matter". Since these are very tiny vessels, this area is the most susceptible to damage.
Periventricular white matter change is seen with age ( can start as early as your 20's), seen with patients with high blood pressure, diabetes, high cholesterol, history of smoking or alcohol. Small bright spots are also very commonly seen in patients with migraines, the cause is unknown.

Again these white spots are " non-specific" meaning that they do not have an underlying sinister cause, and can be seen in any individual with or without neurological complaints.

I do not think that you need another special MRI. Ofcourse if you develop new neurological symptoms, you may need more imaging of your brain, but that will be completely unrelated to these findings on your current MRI.

I hope this helps. Good luck!

[raym13]

Dr. Khan, thank you very much for your detailed, clear response.  That is just the information I was looking for.  Thanks again, and good luck to the other posters on this helpful forum.