Tiny T2 hyperintense foci

[Krishna999]

Greetings experts,

I am Krishna from India. Age 31. Occupation: Software consultant (working from home - night shift - mostly sitting job)
weight: 80 kg (176 lbs) height: 5 "5' (165 cm)

In Dec 2012, I experienced vertigo when I was about to sleep on my left side in the afternoon (since I work at night). It was a horrible experience. Suddenly I got up & sat straight for about 10 min. Then slept all night on my right side. Next morning I tried to lie on left side & vertigo returned (!). From that day for about 3 months I did not lie on left side. It was like I was standing in a boat.

In Feb 2013 I consulted neurologist, after basic examination he just prescribed me betahistine (Vertin 8) thrice a day for 20 days. He did not give any importance to it. But I got my Brain MRI done in Mar 2013.

The boat like sensation is gone. Now I can lie on my left side too. But sometimes I feel a small pain that travels from left shoulder to left side of my back head.

The MRI report is as follows:

MR of the brain was performed using T1, T2, & FLAIR sequences.

Tiny T2 hyperintense foci is seen in bilateral frontal sub cortical white matter and left peri occipital horn region.

Rest of the brain parenchyma reveals normal signal intensity.

The ventricular system, cortical sulci & basal cisterns are normal.

There is no evidence of intracranial haemorrhage / SOL / midline shift.

The visualised orbits are normal.

IMPRESSION:
a.  Tiny T2 hyperintense foci in bilateral frontal sub cortical white matter and left peri occipital horn region - PROBABLY ischemia ? Vasculitis.

b. No other significant brain parenchymal abnormalities detected.

c. No evidence of intracranial haemorrhage / SOL / midline shift.

Please suggest me. I am again going to consult the doctor for small pain in left side.

Thanks
Krishna

[Krishna999]

Thank you Dr. Kaul.

Glad to hear that its not serious. I am consulting Neurologist this Saturday.
I will post what he prescribed & his suggestions.

Thanks once again.

Krishna

[S. Kaul, MD]

Hey Krishna!

The MRI report describes small lesions in the front and the back parts of the brain, possibly secondary to the changes in the smaller blood vessels supplying the region resulting in reduced blood supply. Since the lesions are small these are unlikely to be of clinical significance or responsible for the symptoms described. However there is the risk of further deterioration and it would be advisable to keep factors such as lipid profile, blood pressure, blood coagulability, stress, diabetes etc. under control. I would suggest discussing the situation and the suggested management plan in detail with your treating neurologist.
Hope this is helpful.

Take care!