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Neurology (Expert Forum)
Re: ms and periventricular lesions
This forum is for questions and support regarding neurology issues such as: Alzheimer's Disease, ALS, Autism, Brain Cancer, Cerebral Palsy, Chronic Pain, Epilepsy, Fibromyalgia, Headaches, MS, Neuralgia, Neuropathy, Parkinson's Disease, RSD, Sleep Disorders, Stroke, Traumatic Brain Injury.
Re: ms and periventricular lesions
by CF-Neuro-MD, Jan 01, 1995 12:00AM
Posted By CCF Neuro MD# on February 21, 1998 at 11:29:22:
In Reply to: ms and periventricular lesions posted by hlg on February 20, 1998 at 19:21:09:
: Hello, I have read that the pathologic hallmark of MS is the plaque "which represent discreet areas of demylination , occur often in a perivenular distribution in the lateral periventricular white matter, and the spinal cord white matter contiguous to the pial veins, but may be present anywhere in the CNS white matter". I have also looked at books where MRI scans are shown and reference is made to the periventricular white matter. I know that the ventricles store the cerebrospinal fluid. I have been diagnosed with ON. I have a lesion on the optic nerve and abnormal VEP for the right eye. I have normal VEP for left eye; normal SSEP and normal BAEP. I have 4 silent lesions in the following areas: 1 on the right front beside ventricle; 1 on right middle beside ventricle; 2 lateral periventricular on the left side. The latter 2 had C3 written beside them. These 4 lesions are 3 mm. I do not know how big the optic nerve one is. I have been told I have a 75% chance of developing MS in the next 5 years by my neuro.
The only presenting symptom I had was ON where my vision deteriorated to 20/800. It is now 20/60 after 6 months. I am assuming the 75% chance comes from the ON and the other lesions because my reading suggests ON as first symptom leads to 50-60% chance. This is why I would like to know about the position of the 4 other lesions. I have read and heard conflicting information about the correlation between where lesions are and what symptoms might occur. Some sources say yes whereas other sources including my neuro say no. I should add that I have depression, fatigue, achey (achy) legs, and irritability. That is the background leading me to ask the following questions which I hope you can answer. All I ask is that you be straight with me. Originally my neuro told me that the lesions were in the white matter and what difference did it make where they were? Well it makes a big difference to me. Any information you could give me would be greatly appreciated. Here are the questions. 1. What is the importance of lesions
being in the periventricular white matter? 2. What part of the brain is this i.e. crerbrum? cerebellum? etc. 3. What functions (if any ) are associated with this area? 4. Do lesions in this area so close to where the CSF is stored have something to do with the bbb being breached? 5. What does perivenular mean? 6. Is c3 notation of importance? 7. Are there any symptoms related to having lesions in the periventricular white matter? I look forward to hearing from you and am thanking you in advance for any help you can give me.
=
Some of your questions overlap so I will try to incorporate some answers
into a single section.
The periventricular white matter consists of sheets of nerve fibers which
sweep down from the cerebral cortex to link up with basal structures and other
parts of the cortex, functions are not as clearly localized within this
area as they are in other areas like the brainstem or spinal cord for instance.
The benefit of this is that adjacent fibers can take over the functions of
fibers interrupted by a plaque, this means that it is impossible to attribute
a specific function or symptom to an individual spot, largely because there is
no corresponding defecit, and even if a plaque is present the area may still
have some function left.
The significance of the lesions here is their diagnostic significance as
being very typical of MS, not their localizing value in terms of symptoms or
specific functions, which is negligible.
The lateral ventricles themselves are located in deep part of the cerebrun
and extend deeper in to the third ventricle which ultimately communicates with
the fourth which lies back near the cerebellum.
Perivenular means "close to veins".
Lesions in this area could contribute to a breach of the BBB but are not
obligatory and gadolinium enhancing lesion anywhere in the brain
are by definition causing breach of the BBB.
Four lesions in the white periventricular white matter would be unlikely
to cause specific symptoms, a large burden of lesions could ultimately
cause gait problems, and problems with speech and swallowing.
The annotation c3 on a scan is not one which is familiar to me from any
institution innwhich I have worked, I suggest you ask the radiologist
or your local neurologist who recieved the report.
In Reply to: ms and periventricular lesions posted by hlg on February 20, 1998 at 19:21:09:
: Hello, I have read that the pathologic hallmark of MS is the plaque "which represent discreet areas of demylination , occur often in a perivenular distribution in the lateral periventricular white matter, and the spinal cord white matter contiguous to the pial veins, but may be present anywhere in the CNS white matter". I have also looked at books where MRI scans are shown and reference is made to the periventricular white matter. I know that the ventricles store the cerebrospinal fluid. I have been diagnosed with ON. I have a lesion on the optic nerve and abnormal VEP for the right eye. I have normal VEP for left eye; normal SSEP and normal BAEP. I have 4 silent lesions in the following areas: 1 on the right front beside ventricle; 1 on right middle beside ventricle; 2 lateral periventricular on the left side. The latter 2 had C3 written beside them. These 4 lesions are 3 mm. I do not know how big the optic nerve one is. I have been told I have a 75% chance of developing MS in the next 5 years by my neuro.
The only presenting symptom I had was ON where my vision deteriorated to 20/800. It is now 20/60 after 6 months. I am assuming the 75% chance comes from the ON and the other lesions because my reading suggests ON as first symptom leads to 50-60% chance. This is why I would like to know about the position of the 4 other lesions. I have read and heard conflicting information about the correlation between where lesions are and what symptoms might occur. Some sources say yes whereas other sources including my neuro say no. I should add that I have depression, fatigue, achey (achy) legs, and irritability. That is the background leading me to ask the following questions which I hope you can answer. All I ask is that you be straight with me. Originally my neuro told me that the lesions were in the white matter and what difference did it make where they were? Well it makes a big difference to me. Any information you could give me would be greatly appreciated. Here are the questions. 1. What is the importance of lesions
being in the periventricular white matter? 2. What part of the brain is this i.e. crerbrum? cerebellum? etc. 3. What functions (if any ) are associated with this area? 4. Do lesions in this area so close to where the CSF is stored have something to do with the bbb being breached? 5. What does perivenular mean? 6. Is c3 notation of importance? 7. Are there any symptoms related to having lesions in the periventricular white matter? I look forward to hearing from you and am thanking you in advance for any help you can give me.
=
Some of your questions overlap so I will try to incorporate some answers
into a single section.
The periventricular white matter consists of sheets of nerve fibers which
sweep down from the cerebral cortex to link up with basal structures and other
parts of the cortex, functions are not as clearly localized within this
area as they are in other areas like the brainstem or spinal cord for instance.
The benefit of this is that adjacent fibers can take over the functions of
fibers interrupted by a plaque, this means that it is impossible to attribute
a specific function or symptom to an individual spot, largely because there is
no corresponding defecit, and even if a plaque is present the area may still
have some function left.
The significance of the lesions here is their diagnostic significance as
being very typical of MS, not their localizing value in terms of symptoms or
specific functions, which is negligible.
The lateral ventricles themselves are located in deep part of the cerebrun
and extend deeper in to the third ventricle which ultimately communicates with
the fourth which lies back near the cerebellum.
Perivenular means "close to veins".
Lesions in this area could contribute to a breach of the BBB but are not
obligatory and gadolinium enhancing lesion anywhere in the brain
are by definition causing breach of the BBB.
Four lesions in the white periventricular white matter would be unlikely
to cause specific symptoms, a large burden of lesions could ultimately
cause gait problems, and problems with speech and swallowing.
The annotation c3 on a scan is not one which is familiar to me from any
institution innwhich I have worked, I suggest you ask the radiologist
or your local neurologist who recieved the report.
Member Comments
by michelle2273, Apr 20, 2009 06:05PM
A related discussion, Lesions on MRI Scan/MS? was started.
