MRI (Brain) Results

FINDINGS:  The ventricular system is normal in size and configuartion.  There are several scattered tiny foci of increased T2-weighted signal within the white matter of both cerebral hemispheres.  These are nonspecific.  Differential diagnosis includes demylelination and small vessel ischemic disease.  There are two or three old lacunar infarctions noted in the left basal ganglia.  A linear focus of enhancement is noted extending from the right frontal cortex to the frontal horn of the right lateral ventricle.  This is most consisent with a venous angioma.  I see no evidence of intracranial hemorrhage or acute cerebral infarction.  There are no masses or mass-effect.  The posterior fossa, brainstem, and basal cisterns are normal.

IMPRESSION:  1.  Scattered small foci of T2 hyperintensity throughout the white matter of both cerebral hemispheres.  These are nonspecific.  Differential includes multiple sclerosis and small vessel ischemic disease..  2.  Old lacunar infarctions of the left basal ganglia.  3.  Venous malformation of the right frontal lobe, presumed to represent a venous angioma.  There is no evidence of intracranial hemorrhage.

What does this mean in layman's terms?  Thank you.

[Abhijeet Deshmukh, MD]

Hello.

I will start with the Basal Ganglia. These are important structures. This is the old brain. The humans have evolved over the ages and cells from Basal Ganglia migrated upwards forming the Gray matter. The connections are established by the nerve fibers which together form the white matter.

The MRI shows white matter lesions. These lesions are small areas of cell death in the brain. The cell death has probably occured due to loss of blood supply. An alternate possibility is destruction of the protective myelin sheath (demyelination), that covers the nerve fibers.

There are small blood vessels in teh brain which supply blood to all the parts. The MRI lesions suggest small blood vessel problem.

The basal ganglia are responsible for gross motor activities such as walking, holding a glass of water, etc. The MRI shows lacunar infarcts. This means there was a loss of blood supply to this area. The patient is expected to have some movement disorder or tremors.

The venous malformation may not be significant as far as the clinical symptoms are concerned. The overall picture suggests a possibility of MS (a demyelinating disorder) or a small vessel disease. Even Migraine can produce such small foci of white matter hyperintense lesions.

I hope that was helpful.

Regards