My husband had brain + orbits MRI with / whithout contrast. He was sent to MRI because both of his optic nerves were swollen. Previously he was diagnosed with Birdshot chorioretinopathy.
Here is the report. Can you please explaine what it means. Is it good or not? Thank you all in advance.
- There are several scattered foci of increased signal peripherally distributed within the periventricular white matter. No immediate subependymoma, S. left temporal lobe white matter lesions are evident. There is no evidence of diffusion restriction. There is no evidence of pathologic enhancement. The venricles, cisterns and sluci appear normal. There is no evidence of mass or hemorrhage.
There is mild maxillary and ethmoid sinus mucosal thickenning. No air-fluid levels are identified.
IMPRESSION: SEVERAL NONSPECIFIC FOCI OF INCREASED SIGNAL WITHIN THE PEROVENTRICOLAR WHITE MATTER. NO COMPELLING SUGGESTION OF DEMYELINATING DISEASE. NO EVIDENCE OF ABNORMAL ENHANCEMENT.
IMPRESSION: SYMMETRICAL PROMINENCE OF THE SUPERIOR OPHTALMIC VEINS-A FINDING OF UNCERTAIN SIGNIFICANCE. OTHERWISE UNREMARKABLE MRI OF THE ORBITS. NO EVIDENCE OF INTRINSIC OPTIC NERVE LESION.
As far as the periventricular white matter changes that you are describing...these are most commonly reltated to "small vessel ischemic changes". I have commented on this pretty extensively in recent posts, and would ask you to look at some recent posts I have made about small vessel ichemic changes for a complete answer...but in a nutshell, these changes are very very common and nearly always (but not always) related to small vessel ischemic changes which is most commonly related to hypertension, diabetes, smoking, and just age.
As far as prominence of the opthalmic veins, it sounds based on their description that their is no specific reason that they identify as to the reason. The one pathologic reason that comes to mind why the superior ophthalmic vein may be enlarged is something called a "cavernous-carotid fistula", however this is very rare and in this setting usually the opthalmic vein is greather than 4 mm in diameter (very prominent) and often asymetric. So based on the description you provide, it's probably just the way he is built...
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