poss stroke

[john-lewis]

  I am a 31 yo whitw male, who has been having lighting sharp pains down the left side of my face radiating from above the ear. I was diagnosed with trigeminal neuraliga approx. 5 yearss ago and was started on tegrotol, which i could not take. then i was placed on inderol which helped alot but it lowered my pulse rate to much. just recently i have been geting bad headaches and went to see my internist who started me on steroids and ran a ct scan just to be sure. the ct came back abnormal and i was sent to a neurologist after receiving an mri for the abnormal ct scan. i did not have the radiology report but had copies of the mri. the neurologist said he did not read mris. My internist wants me to have an mra. The mri report read as follows" cranial mri wo / w iv contrast gadolinium is performed for the evaluation of white matter disease. the ventricals and basal cisterns are normal. areas of increased signal within the white matter bilaterally are identified within the parietal region. no enhancement following iv infusion of contrast is seen. no abnormality on diffusion imaging is identified, hence indicating that these areas of increased signal represent old lacunar disease and not an acute infarct.  Opinion:  Bilateral parietal white matter disease, chronic". What does this mean , no one will tell me are they small strokes or ms, is an mra indicated. thank you
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Thanks for your question.  It difficult to provide full comments on the
results of your MRI scan without actually looking at the films.  Small
bilateral infarcts in the deep white matter are NOT uncommon findings in
OLD, hypertensive patients, and quite often these infarcts can go un-noticed
by patient and family members, although if they are numerous enough they
will eventually cause significant neurological impairments (cognitive,
motor, sensory, etc.).  However, those generalizations would NOT apply to
your case, given your young age, and lack of significant medical problems (?).
MS lesions are usually located in deep white matter, but the symptoms
described in your message are not typical of MS.  The MR-Angiogram (MRA)
is recommended if your physician is considering the possibility of stenosis
(narrowing) of the intra-cranial blood vessels as the cause of the lacunes
(small infarcts), but the lesioned vessels that usually cause lacunes are
too small to be properly detected in MRAs.
I hope this information is helpful.  Best of luck.
This information is provided for general medical education purposes only.
Please consult your doctor regarding diagnostic and treatment options.