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Migraines
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Migraines

Hi there,
I've been having migraine headaches with and without aura for 10 years or more.  I went in and had an MRI done and here are my results.    
In the left periatrial white matter, there is a 6 mm T2 mildly hyperintense,
FLAIR and T1
hypointense lesion, with mild surrounding hyperintense T2 and FLAIR signal.
There is also
a nodular area of increased T2 signal at the periphery, seen on series 7 image
18. There
is no definite internal enhancement. There is a mildly prominent adjacent
blood vessel.
On sagittal MPRAGE images, there are surrounding linear T1 hypointensities.
There are
scattered periventricular and subcortical white matter T2/FLAIR
hyperintensities, for
example seen in the left inferior right frontal lobe on series 8 image 15, and
in the
periventricular white matter as seen on series 8 image 19 and 20.

No additional masses are seen. There is no evidence of ischemia or hemorrhage.
Intra and


IMPRESSION:
Small focal lesion in the left periatrial white matter as described above.
There are also
nonspecific scattered T2/FLAIR hyperintensities, more than expected for
patient age.
Given this combination of findings, the left periatrial lesion could represent
an old
demyelinating lesion, with other scattered demyelinating plaques.
Alternatively, this
could represent a dilated perivascular space with adjacent white matter
lesion. White
matter lesions can also be seen in the setting of prior infection or trauma,
chronic
small vessel ischemic disease (unlikely given patient age), or migraine
headaches. The
size of the left periatrial lesion would be atypical for migraine headaches. A
less
likely consideration for the periatrial lesion is a small old lacunar infarct.
1711789_tn?1361311607
Hi there!

The report described scattered area of hyperintensities, most probably representing ischaemia/ reduced blood supply and  a possible demyelinating lesion located in the periatrial region where a few differential diagnosis may need to be considered and evaluated for based on a clinical evaluation. I would suggest discussing the situation and the suggested management plan in detail with the treating neurologist.
Hope this is helpful.

Take care!
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