Does this MRI mean mini-stroke, MS or worse?

[Archbishop]

A copy of my 78 yr old mother's MRI given for slow, progressive weakness on left leg/hand, and "heavy, lead-filled left foot" as she describes it, coming over her during pas year or so.  The left hand has little strength, but there's clear signs of her OA there. She has chronic edema in both lower legs, and is now using comp stockings, and has NOT been active or walking at all for more than that year.  Does the impression #1 mean she's had a mini-stroke, or has MS, or that there is something progressive that's responsible for her heavy, weak leg/foot? Is there a treatment for what she has and if so, is this something that's worsen?
HISTORY:
Patient with slowly progressive leftsided weakness.
The ventricles, cisterns and other CSF containing
spaces are diffusely prominent but otherwise normal in shape and
position. The brain parenchyma is remarkable for confluent
periventricular and slight brain stem T-2 and FLAIR hyperintensity in a pattern and distribution most consistent with gliosis due to ischemic small vessel disease. There is no evidence of a focal mass, midline shift or of acute intracranial hemorrhage. There is no evidence of restricted diffusion on DWI or ADC images.
FINDINGS:
IMPRESSION:
1. Prominent CSF spaces combined with white matter signal abnormality in a pattern and distribution most consistent with
gliosis due to ischemic small vessel disease.
2. No evidence of focal mass, midline shift or acute intracranial hemorrhage.
3. No evidence of acute ischemia or acute focal demyelination on DWI.
THANKS very much,
The Archbishop

[CCF-Neuro-M.D.-PW]

I cannot give a formal opinion of the MRI without seeing it, but based on the report it shows nothing abnormal for a woman her age. This would tend to make MS, or a major stroke unlikely. Sometimes small strokes occur in the white matter or in thebrainstem that are not so clear on MRI but the clinical history of slow preogression does not support a stroke. A tumor has effectively been ruled out by MRI, but was another thing to consider.

Non-neurological isssues need to be addressed also, is there arthritis that happens to be worse on the left side/hip etc, is there any musckulosketelal injury on that side ie a fracture. Then is there any evidence that it is a peripheral neuropathy liek carpal tunnel at thewrist or a nerve root problem in the cervical spine (A common probelm and cause of such symptoms in the elderly).  A good physical examination should be able to sort out what category of where and what needs to be tested to find the cause.

Good luck

[Archbishop]

Thank you so very, very much!  I had horror stories in my mind of the death of my mother's brother from complications from MS (which took place back when I was 1 year old) and then there was the stroke worry.  Her MD doesn't see her until the 23rd of Janurary, and while an Anglican Archbishop has as much faith as anyone else, when it comes to someone so treasured, I could not wait on learning whether or not "to worry" about a few of the biggies.  I think her recent lack of movement and lack of going out (for the past 9 months - not through her own fault) has a lot to do with her decreasing ability to move, and that she MUST keep moving (which she has agreed to go out more now and now has the ability).  

This service you provide is, in my opinion, more valued than virtually any other use of the Internet.  I will keep you and YOUR loved ones in my prayers - permanently!  I will! God bless you and yours - you've made my holiday season!  All blessings,

Archbishop H.