Just Curious

[mackemuk]

Hi All. I Have A Question, What Does The Radiologist Mean When He States In My Report.
Other Demyelinating Change Not Excluded.
Take Care Everyone.
Joe.

[Quixotic1]

Well, my take on this is that the radiologist doesn't have any opinion at all about the nature of the lesions.  He/She chose the Ischemic lesions as being most probable only because of your age.  At age 50 you might have some age-related lesions, but the doctors have to look at it this way:

The MRI has to be evaluated in the light of "Why was the MRI done in the first place?"  If it was done to look for lesions because of significant neurological symptoms, then any lesions found MUST be considered as possibly related to those symptoms.  So, any thinking neurologist must keep the fact that you have lesions in mind.  they should not be dismissed as "normal for age" which is what the radiologist is vaguely suggesting.

Remember that the radiologist's interpretation is made in isolation.  The radiologist doesn't know what all of your history is nor what your neurologic exam looks like.  It is okay for him to say that "statistically" the most common thing is that the lesions are from tiny vessel ischemic disease (age-related).  But, notice he does not state that very definitely.  He leaves room to call these "other demyelinating causes" based on the total picture of you, your history and your exam.  The neurologist is the one who should put the whole picture together.

In general, in middle aged people, the tiny lesions seen as age-related do not cause symptoms.  So, if you have symptoms and/or an abnormal neuro exam, then one has to consider that these lesions may well be one of those "other demyelinating" disorders.  the most common one of those disorders is MS.  And YOU ARE NOT TOO OLD FOR MS.  THERE IS NO UPPER AGE LIMIT FOR MS TO APPEAR OR TO BE DIAGNOSED!.  Don't let any doctor tell you this.

Was I clear here?  this is a subtle point that many neurologists don't get and most people don't understand.

Quix

[wonko]

Hi, can you tell us if/what your diagnosis is?  That could help in picking apart the report.

I'm no expert, I have no medical training, but I agree with JemmAus's interpretation.  S/he is leaning toward ischemic, but they can not rule out demyeleination.

Has your doctor ever talked to you about ischemic attacks, or have any of your prior MRIs (if you've had ones prior) had this in the report?

I can't remember for sure, but I thought you had an MS diagnosis.  If so, maybe the radiologist just can't tell if the MRI shows signs of MS, or if you may also have some ischemic spots.  I hope your doctor/neuro can make more sense of it.

Good luck!

[mackemuk]

bump

[JemmAus]

Sounds like it means he THINKS the lesions are ischemic but he won't rule out other things causing them as well........

[mackemuk]

Sorry Gang I Should Have Quoted The Whole Paragragh Which Is As Follow's,
Appearances Are Probably Consistent With Tiny Foci Of Demyelination And In Conjunction With Patients Age Group The Most Likely Differentail Diagnosis Is Ischaemic Foci. Other Demyelinating Change Not Excluded.
I Would Be Very Interested To Hear The Forum's Views.
Look After Yourselves Everyone.
Joe.