MRI results

[mom21boy2]

I a cat scan done because of dizziness and then a MRI was done because of something abnormal on the cat scan.  The impression of the MRI said there are multiple areas of abnormal signal intensity in the cerebral white matter.  A demyelination process would be a strong consideraton.  Nonspecific nonacute microvascular changes with a vasculitis would also be in the differential diagnosis.  Can you please explain what this means?  My dr. is sending me to a neurologist, but I am not sure how long it will take to get into one and I would like some more information on it.

Thank you

[mom21boy2]

Also can you explain more what demylinating disease is and are there different types?  I am interested because that is what it had on the MRI report (done with and without contrast)

[mom21boy2]

I do not smoke, have diabetes, have high cholestorol or high blood pressure.  Can you please explain further what vasculitis is?  

[Shazia Alam, DO]

There are multiple causes for so called plaques 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. This is not a disease in and of itself but rather is a reflection of unhealthy blood vessels, damaged by years of 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 of plaques in the brain can be migraine. People with migraine often have plaques on their MRI that are of unclear cause or significance.

Other causes of plaques on MRI can usually be distinguished based on history and symptoms, such as symptoms of neurologic deficit (for example arm weakness or difficulty walking etc).

These can also be distinguished based on the MRI appearance. These include, but are not limited to, multiple sclerosis, other demyelinating disease, and inflammatory processes such as vasculitis.

If you do smoke, have high blood pressure or cholesterol, it is imperative that you stop smoking, take medication to control your blood pressure, cholesterol, and diabetes, eat a healthy diet, and exercise.

The different causes can be determined to some extent by interpretation of various sequences of the MRI.  Other investigations are sometimes necessary to distinguish the various causes of white matter lesions. A lumbar puncture is sometimes necessary, in which fluid from around the spine and brain is taken out and analyzed with various tests.

Hope this information was helpful.