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White spots in the White matter area of the brain
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White spots in the White matter area of the brain


  What does it mean when the doctor says they have found white spots in the white matter area of the brain? I still can't find any specific info. on the white matter area of the brain. Also, what are white spots? My neurologist says that she thinks it is fluid built up in the arteries of my brain. I am a little concerned over this, specifically when she states that we should approach this aggresively conservatively. I'm not a doctor here, but fluid and arteries of the brain and whatever white matter does doesn't sound reassuring. Any help would be great!
  Thank you
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This is a common occurrence.
An MRI of the brain is done on an individual because of some symptoms. It comes back basically normal, except for these "bright spots" and then the question is whether they mean anything.
Usually, the report reads something like this (look yours up and see if it matches closely): "... scattered punctate small hyperintensities in the hemispheric white matter on the T2 weighted images. Consider possibly demyelination, ischemia, or changes associated with migraine. This may also be a variant of normal. Clinical correlation is advised ..."
These bright spots are often a variant of normal, and the interpretation is that there are spaces surrounding some small blood vessels that show up like this on the scan. This is quite common.
Basically, then it's up to the neurologist. When I see patients, I formulate a hypothesis about where the problem might be (if indeed a neurologic problem can be defined). Then, if I can't decide the possibilities without a scan, I may order an MRI. That way, when the report comes back, there is some context in which to interpret the results. I think most neurologists think in this fashion.
The radiologist truly cannot tell the difference between abnormal and normal (for these specific types of bright spots) based strictly on the appearance. That is why he/she says "need clinical correlation." That is, fit the information you provide in the interview as well as your findings on exam with the data from the film.
By the way, white matter is the stuff in the core of your brain where all the cables are going. It's white because of the myelin coating around each axon (nerve fiber) which is carrying information from somewhere in the brain to somewhere else. There is a thick layer of grey matter on the outside surface (cortex), and there are various collections of cells in the center of the brain and in the brain stem. The rest is wiring (white matter).
I hope this helps. CCF MD mdf.





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