MRI and white matter spots

Hi. I am a 28 year old female. I had an MRI of my brain done a while ago and just read the radiologists report as I am now filing for disability. The report states that there are several white matter spots on the frontal areas of my brain. There are also areas of increased signaling. I asked my own neuro over the phone and the nurse said that he was "unconcerned" but wanted me to come in. I initially saw him for neuropthy of the feet and hands. I do not have diabetes. I was dxed with fibromyalgia, SI joint disease, OA, slight bulging discs, narrowing of the spine, among many other things. I am going to a new rheumatologist and I plan on bringing this up. I am aware that lesions could mean MS. While I am not diagnoising myself, I do show signs of that disease and there is a family history. My question is are white matter spots and lesions the same thing? Are white matter spots something to not be concerned about? If so, why would the radiologist note it as abnormal in the report?

[Neuro Forum]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.

Without the ability to obtain a history from you and examine you and review your imaging, I can not comment on what the implications of your imaging findings are. However, I will try to provide you with some information regarding this matter.

In general, in an MRI report, the term lesion refers to any finding; other terms often used synonymously in the context of your findings would be white matter plaques, white matter changes, or white matter lesions. There are multiple causes for so called white matter lesions in the brain. Most often, these are due to what is called "chronic small vessel disease", literally meaning diseased small vessels that supply blood flow to the brain. This is not an uncommon process in the brain and increases with age, but in a diabetic such as yourself they can appear at an early age. This is not a disease in and of itself but rather is a reflection of unhealthy blood vessels, damaged by plaque build-up. This is most often due to a combination of several factors including the following: high blood pressure, diabetes, smoking, and high cholesterol. If these factors are well controlled, the damage to the brain can be stabilized and further damage prevented. Other causes include, but are not limited to, migraine, multiple sclerosis, other demyelinating disease, and inflammatory processes such as vasculitis, but these would have to be taken in the right context of the patient. Obviously some of these are much more serious than others. The radiologist describes what he/she sees regardless of how serious the finding is, he/she makes a comment on the presence of the lesions and the potential possibilities, but the neurologist will be the one to determine their relevance based on other factors. The specific location and appearance of the lesions, combined with your physical examination and history, and possibly other testing, aid the neurologist in determining the cause of the lesions in the brain.

Continued follow-up with your physicians is recommended.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.

[hatbox121]

I am NOT diabetic. That's why the neuropthy had my regular physican puzzled, along with contractures of the hands. That's why I was sent to the neuro.

[Carla46501]

Hi I also have white matter/lesions on the brain, my family has a history of it, along with this white matter with get migraines.  We are diagnosed with Cadasil.  please get in touch with me to discuss.  Thanks