Re: MRI Results

Posted By Kelly on June 13, 1999 at 10:20:12
I would like to thank you in advance for your time. Could you please help me to understand the following report from my most recent MRI of head.
A couple of tiny foci are seen in the inferior aspect of both basal ganglia on the PD and T2 images which probably represent prominent perivascular spaces or possibly lacunar infarctions.  A tiny hypodensity is seen in the left basal ganglia (globus pallidus) on the PD and T2 images.  There is no evidence of mass, midline shift or other significant abnormality of the brain substance.  The ventricles and cisterns are unremarkable with no evidence of enlargement or displacement.  No abnormality of the brain stem, cerebellum, or other posterior fossa structures identified.  No extra-axail abnormality noted.  The cervicomedullary junction is normal.  Some hyperintense signal is seen on the PD and T2 images in the right maxillary sinus.
This MRI was ordered by my opthamalogist due to decrease vision in my right eye.  When I returned to him for the results, he told me it showed an old 'small stroke'.  However, my neurologist seems unconcerned about this.
Does this indicate an old stroke?  Would that explain the weakness on my right side, especially arm and leg?
Please help me to understand what is going on.  
Thank you again for your time and this service.  This is a wonderful web site.

[CCF Neuro[P] MD RPS]

Posted By CCF Neuro[P] MD, RPS on June 13, 1999 at 11:40:51
Dear Kelly:
From your description (probably from the report by the radiologist) it is difficult for me to tell you what is meant.  I am not sure what "PD" means.  Usually, we get T1, T2, Diffusion, Perfusion scans if examining whether a stoke occurred.  The tiny hypointensity seen in the globlus is likely Virchow-Robin spaces.  These are subarchnoid spaces that surround blood vessels and will give tiny circular hypointense areas.  Now, if the other description was hyperintense spots in the basal ganglia on T2 weighted images, then this might represent old infarcts as mentioned.  If you have a history of hypertension or diabetes, then it would fit with the finding.  If these areas would be hyperintense on the diffusion weighted scans, then it would indicate acute infarction.  
However, since the report said either possible perivascular spaces or old infarct, I will assume that the radiologist was not suspect of old infarct but only gave it as a remote possible cause of the small tiny foci.  The language of some radiologist leave alot to be desired and it is often hard to pin point the lesion unless it is seen by the neurologist or is very obvious.
I am sorry I couldn't help more.  My guess is that it is all benign Virchow-Robin spaces.
Sincerely,
CCF Neuro[P] MD

[PD--proton-density]

Posted By PD = proton density on June 13, 1999 at 12:56:02
Nothing to add to above.











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