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MRI Question
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MRI Question

I went to the doctor with symptoms of muscle twitching (past 2 years), stiff joints (past year), dizziness, numb tingly feeling hands, arms, feet and random sharp shooting pains in head.  He sent me for an MRI of my brain. I had blood tests a year ago to check for Arthritis because of stiff joints and it was negative.

The MRI findings:

Small focal area of gliosis involving left superior frontal gyrus. There are a few small nonspecific cerebral hemispheric T2 hyperintense foci likely reflecting sequelae of chronic small vessel ischemic change or vascular headaches. There is no intracranial hemmorrhage or mass.  No abnormal extra-axial or parenchymal fluid collections. The ventricles and basilar cisterns are normal. There is no evidence of restricted diffusion to indicate acute infarction.

The major arterial and venous flow voids are unremarkable. The posterior fossa and inner ear structures are unremarkable. Likely reactive fullness of the adenoidal pad. The orbits are unremarkable. Multifocal paranasal sinus mucosal thickening, most pronounced on the ethmoid air cells bilaterally. There is debris in the left maxillary antrum with air- fluid levels in both maxillary antra.  The pituitary gland is unremarkable. The bony calvarium appeas unremarkable.

What may this suggest.  I don't suffer from migranes (migraines), I do have history of sinus infections and I have Factor V Leiden.  No other health issues.

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1268057_tn?1379102055
What does the "impression part" of the report state?  
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Avatar_f_tn
It says:
Cerebral hemispheric white matter changes may reflect sequelae of vascular headaches or chronic small vessel ischemic change. No evidence of acute infarction.

Findings suggestive of multifocal sinusitis.

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1268057_tn?1379102055
"Multifocal paranasal sinus mucosal thickening, most pronounced on the ethmoid air cells bilaterally. There is debris in the left maxillary antrum with air- fluid levels in both maxillary antra."  This definitely correlates with your sinus issues.  

The other symptoms aren't really being explained in regards to the MRI of the brain/head.  I would recommend going further down the spine and getting an image of your cervical spine.  

Have you seen a Neurologist at all?
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Avatar_f_tn
Thanks.  I have not seen a neurologist.  I am still waiting to hear from my doctor and my guess was he would refer me.  He is only in the office on Mondays so hopefully I hear then.
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1268057_tn?1379102055
Keep us posted.  
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Avatar_f_tn
Will do.  Do you happen to know what the second part means even though it doesn't fit with my symptoms?

Cerebral hemispheric white matter changes may reflect sequelae of vascular headaches or chronic small vessel ischemic change. No evidence of acute infarction.
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1268057_tn?1379102055
Chronic small vessel ischemic changes are usually related to a history of long standing hypertension (high blood pressure), Diabetes or some other inflammatory conditions of the blood vessels related to infection or a disease.  

The other situation that could explain these changes in the cerebral hemisphere is a history of migraines.



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Avatar_f_tn
That's kind what I have read and have been confused since I have never had high blood pressure, diabetes or migranes (migraines).  
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1268057_tn?1379102055
Inflammatory conditions related to disease or infection can also cause these changes as well.  
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Avatar_m_tn
I had an MRI and it states the "Impression" to be:
1. The Periventricular deep white matterT2 and FLAIR hyperintesities are non specific and may represent sequela from chroic small vesel Ischemic Disease.  In a patient of this age, a vasculitic process could have a similar appearance.  A demyelinating process is thought less likely, however, not entitrely excluded and clinical correlation is suggested.
2.  Cerebellar tonsil ectopia measuring 3-4 mm.

Can anyone help me w/ the diagnosis.  The Neurologist said "Well, if you were 24, I'd say you had MS".. "However, I don't think you have MS".  I am scared... I have memory loss, tremors and headaches.  I am a Female and just turned 42.  
Any help would be appreciated... Thank you..
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