Do I need to worry?

[trudee]

I had a mri done on my pituitary and this was the results. FINDINGS: Flair imaginging demostrates approximately 8 subcortical white matter areas of signal alteration. These have increased in number as compared to prior examination. There are two new lesions within high vertex posterior frontal subcortical white matter. There another new lesion present within the white matter adjacent to the frontal horn of the left lateral ventricle. There is no abnormal enhancement associated with these lesions. This is suspicious for progresson of demyelinating disease. Diffusion weighted not performed. There is no mass effect or midline shift. The basilar cisterns are patent. The intracranial flow voids are preserved. The midline structures are preserved. An empty sellar is again notrd. Dedecated imaging through the sella demonstrates no evidence fo sellar or suprasellar mass. There is normal enhancemen of the pituitary glan. The pituitary stalk is midline. The cavernous sinuses and cavernous internal carotid arteries are unremarkable. The optic chiasm is unremarkable. There is an incidental mote of increased fluid within the left mastoid air cells which has increased as compared to last examination.

[Lama Chahine, MD]

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 and view your imaging, I can not tell you what the exact implications of your MRI findings are. However I will try to provide you with some useful information.

The main finding on your MRI seems to be "subcortical white matter areas of signal alteration". There are many possible causes for these so-called white matter abnormalities. As mentioned in the report, when new lesions are found compared to a prior MRI over a relatively brief period of time (months) in a person below age 50-60, one possibility is a demyelinating disease such as multiple sclerosis. However, multiple sclerosis is not diagnosed strictly based on MRI, but rather based on the combination of history, physical examination, and MRI findings. Other possibilities for white matter lesions in someone younger than age 50 include inflammatory processes such as vasculitis (inflammation of the blood vessels in the brain due to for example an autoimmune disorder) and migraines. In people older than 50, disease of the small vessels of the brain due to smoking, high blood pressure, high cholesterol etc. would be the most common cause of white matter abnormalities.

Some sinus disease also seems to be present on your MRI, but this does not necessarily mean you have sinusitis, it depends on the exact MRI appearance.

It is important to follow-up with your physician in order to better understand what the exact implications of your MRI findings are.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.