HELP for my husband

[mariemomof4]

My husband is 39 and in general good health.  Does not drink, smoke or use drugs.  Is not taking any medications.
About a year ago he would have these "black outs"  No pain, no warning, he would just lose his vision.  Only for a few seconds to less than a minute and then he would be fine.  About a month ago he started having headaches that start in the back of both sides of his head and move to the front via the sides of his head.  He complains of nausea, dizziness and inability to focus or concentrate.  I finally talked him into going to family Dr and family doctor ordered MRI (with and without contrast) and blood work.  Only thing on blood work that was abnormal was ALT and AST but I don't see how those would effect brain.  MRI as follows:
The ventricles and sulci are normal.  No definite signal abnormalities are noted in teh brain or brainstem.  On axial T2 and FLAIR sequences, there are tiny slightly curvilinear areas of apparent increased signal in the white matter of both parietooccipital lobes, but the appearance and configuration suggests these probably represent posterior extensions of the ventricular system rather than white matter lesions.  No other signal abnormality is noted in the brain or brainstem, and no mass or enhancing lesion is seen.  
Family doctor ordered an MRA based on these findings and that came back "unremarkable"
I am trying to get my husband to go to Cleveland Clinic neurology because I feel the neurologist we have and appointment with is just going to read the report and not look at any of the films and tell my husband he is fine.  I believe the Cleveland Clinic would take the time to talk to my husband and look over his films and not go based on what someone else saw.
Are there any suggestions as to what this "white matter lesion" might be?   I'm assuming that they are lesions because of my husbands symptoms.
Is it possible it could be a cyst?
Any help would be greatly appreciated.

[selmaS]

I enjoyed our talk as well. And I hope I am offering info that is helpful.
as to ur husbands "head or neck trauma"....a fall at the end of a slide, off a swing,....monkey bars....can be enuff to cause an injury, but not a lasting impression.That's not to say a fall from childhood has sparked some major problem.....just if there r no other answers maybe it should be looked into.


below are from two seperate web pages....it is info on spinal taps:
regarding the migraines...I believe it depends on how severe they r wether or not there will be leisions.And again it depends on the severity on which meds if any will offer relief.Try not to rely on Tylenol  ( or acetaminophen) for frequent headaches as it can lead to problems with the liver.
and he could be right that the problem may not be in his eyes...it could be, but I went thinking my eyes were a peoblem and nothing showed on the exam.If it is  something neurological it will not show on an eye exam.






A spinal tap is a procedure performed when a doctor needs to look at the cerebrospinal fluid (also known as spinal fluid). Spinal tap is also referred to as a lumbar puncture, or LP.)


Some of the reasons your doctor may want to do a spinal tap include the following:


To look for infection


To check to see if there is bleeding around the brain (subarachnoid hemorrhage)


To look for causes of unexplained seizures


To look for causes of headaches


How Does a Spinal Tap Assist in the Diagnosis of MS?
A spinal tap that reveals a large number of immunoglobulins (antibodies) as well as oligoclonal bands (the pattern of immunoglobulins on a more specific test) or certain proteins that are the breakdown products of myelin is suggestive of MS. These findings indicate an abnormal autoimmune response within the brain and spinal cord, meaning that the body is attacking itself.


keep me posted
Godspeed
"selma"

[mariemomof4]

Hi Selma,  Thanks for the post and it was great "talking" to you last night.  My husband has had some of the levels checked but not all of them.  He also has not had his thyroid checked.  Both of those things are on my list to ask about at his neurologist appointment.  My husband insists he is not having migraines (don't know how he thinks he can tell)  I'm assuming because he says they aren't extremely painful to the point of making him vomit or being sensitive to light.  If it were migraines would tylenol make them go away or does it have to be a prescription for migraines?  I know he has taken up to 1000 mg tylenol with no relief.  He just started with these symptoms about a month ago.  If it were a migraine would the lesions show already?
I have made him an appointment to get his eyes checked but he is also insisting that he doesn't think it is his eyes either.  
He has never had a head trauma that he can remember but he is going to ask his parents.
I assumed that sinus and ear were ruled out with the MRI and as far as infection his WBC count was perfect.
What do you know about doing a spinal tap?  What would that show?  I'm not sure if we are at that point yet but it is just so frustrating to NOT KNOW what is going on.
Thank you again for all you information and just for someone to vent to :-)

[selmaS]

Hi, has ur husband had all his vitamin and mineral levels checked...along with his thyroid levels?....many who I have talked with including myself have found we have a brain fog...which fits the description u mentioned....and we have a thyroid condition.....I also have blurred vision and at times it's like something floating in the way and blocks the vision...I've been to the eye dr and it does not show up on exam.
As for the white matter in ur husbands brain.....the fact it could be from a trauma as well as past migraines is possible...ask him to think about it ...he may remember a fall or accident he thought was not relevant.
I have also read that sinuses can also plat apart in symptoms such as these.....check for an infection.....also check the inner ear.

Good luck
Godspeed
"selma"

[mariemomof4]

Thank you for the information.  How is this diagnosed?

[Danielle718]

Look up Ocular Migraine. I had one a few months ago where your vision is gone or impaired for a few moments and then come back. They are painless and they are caused from migraines.

[mariemomof4]

Thank you so much for your response.  I was wondering about migraines but my husband doesn't complain so much of the headaches being extremely painful and they pretty much just started.  He is more worried with the inability to focus and concentrate.  Is alzheimers hereditary?
Thank you again for your response.

[DrNoopurMD]

Hi,

Thanks for writing back.
Two possibilities come to mind one is stroke other is migraine. Since his MRA has been normal stroke at this point does not seem to the cause. Migraine is a possibility because of his symptoms of headaches, visual symptoms, nausea and dizziness.
The white matter lesions in the brain can occur due to chronic headaches, migraine, stroke, high BP, diabetes, brain infections like encephalitis, old age, alzheimer’s and MS.
Cysts are seen as isointense areas on MR, since the findings are of increased signal intensity, cysts appear to be unlikely.
Hope this helps!