I am a 34 year old female with a history of migraines.Over the past five years they have become severe and I get really bad ones 2-3 times a month. I have had three MRI's done since 2001. The first one noted a single white matter hyperintensity around the subcortical white matter, the neurologists said that it was a UBO and not to worry about it. The headaches got worse again in 2003 and a second MRI was ordered. This one showed multiple small hyperintensity T2 and FLAIR foci. Again, told nothing to worry about. Now, in 2005, yet another MRI that showed scattered small foci of high T2 signal abnoramilty in frontal lobes and convexities. The neurologist ordered bloodwork and an echo with doppler study.The echo showed a dilated right ventricle and a dilated ascending aorta.I am trying to understand what all of this means. I don't smoke, drink, have high blood pressure, take birth control pills or any of the other risk factors that would make sense. What is the take on this? I'm confused as to if these are related syptoms. Any comments or information would be greatly appreciated.
Migraine is associated with these small areas of high signal on MRI. The exact reason is unclear but may be related to the vasoconstriction (spasm of blood vessels) associated with migraine attacks
The changes can also occur in a variety of other conditions such as hardening of the arteries, hypertension, vasculitis, demyelinating disease, and toxins. While migraine may indeed be the cause, your doctor is correct in looking for other potential causes which might need different treatment such as a careful evaluation for hypertension (24 hour BP monitor and echo), stroke risk factors (which you do not seem to have, get cholesterol checked also), vasculitis/inflammation (some blood tests like sed rate, ANA, maybe cerebrospinal fluid analysis)
I am limited in commenting on echocardiogram abnormalities - a dilated right ventricle and aorta (without evidence of clots) are not a definite stroke risk factor as we know it, the results may be congenital (there from birth) or may be secondary to cardiovascular or pulmonary disease - I do not have further information to comment more specifically, please seek your doctors opinion
I cannot give you a definite diagnosis or followup so you should talk to your doctor about your concerns
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