MRI Results

[GrannyKay]

Hi. I have been posting here in the MS section because my neuro just started a series of tests thinking MS might be causing my symptoms. I've had issues with chronic pain, both achiness/burning in muscles as well as sharp shooting pains in all different parts of my body. I have also had many gastrointestinal issues.

The most recent things to come up have been chronic uveitis, started last May, and vertigo which started again last December. I had  one isolated incident of vertigo a few years ago, but it went away within a day and I figured it was just a flu. This time it started out severe but only lasted a few hours .... but I've continued to have milder/shorter episodes of vertigo since then, several times a week.

These two issues prompted my gp to send me to a neuro, who wondered about MS.

She ordered an MRI and an LP, both of which I had last week. I have been miserable since the LP, which I had done Thursday (today is Monday), with a headache and last night/this morning started having gi problems, which I don't know if its related to the LP or not, but its been awhile since I've had any of these issues.

I got the MRI report this morning. This is what it says:

The lateral and third ventricle are enlarged for age. There is NO evidence of associated transependymal fluid migration. The fourth ventricle appears normal. The suggest the possibility of obstruction at the aqueduct of Sylvius. NO mass or other space occupying abnormality at the aqueduct is demonstrated.
There are bilateral hemispheric white matter foci of T2 hyperintensity involving subcortical and periventricular white matter. These do NOT exhibit mass effect, evidence of hemorrhage, diffusion restriction or abnormal enhancement. Appearance is most suggestive of chronic small vessel disease although, again, somewhat prominent for age.
Examination appears otherwise normal. NO other congenital malformation or abnormality is demonstrated. Craniocervical junction appears normal. NO other cranial space-occupying abnormality is demonstrated. NO other abnormal enhancement is demonstrated. There is NO evidene of ischemia on diffusion-weighted sequences.

Impression: Enlarged ventricles, suggesting fixed or functional obstructing abnormality at the aqueduct level. Nonspecific hemispheric white matter signal intensity pattern changes, likely related to small vessel disease.

Can anyone tell me what this means?? Thank you!

[GrannyKay]

Thank you for your response.

I have been tested for lupus a few times and it has always come back negative. I was showing some slightly elevated sed rates (39) back in May 2012, but have been working on dietary changes and taking supplements, including fish oil, to help with this and the last time it was tested (last November I believe) it was down to 20.

I definitely have inflammatory issues - a lot of gastrointestinal problems but the main thing they are concerned about in that area is severe diverticulosis throughout my entire colon. Their solution to that is to remove my entire colon because I've had recurrent infections and one very bad bleed that required 4 blood transfusions. So far I've avoided having the surgery, against my doctor's recommendations.

I have also been tested for Lymes disease and Sarcoidosis both came back negative.

I have ordered a CD of my MRI so I can have it evaluated by an MS specialist just to see what he says.

[Paderla Anitha, DNB]

Hello and hope you are doing well.

The report shows an enlargement lateral and third ventricle, but no evidence of obstruction. This needs to be correlated clinically. In Small vessel disease the lumen of the small blood vessels is narrowed causing a decrease in flow. Considering your symptoms of chronic uveitis and vertigo, and small vessel changes. it could be related to inflammatory disorders like systemic lupus erythematosus.

Usually a diagnosis of multiple sclerosis can be made over months to years and it is based on MRI, electrophysiological potentials from the brain and the presence of abnormal cells in the cerebrospinal fluid (fluid surrounding the brain).

Hope this helped and do keep us posted.