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MRI Results

White matter: There is ill-defined faint high T2/FLAIR signal within the deep right frontal and periventricular white matter. No evidence of mass effect or enhancement. This is best seen series #8, image #19 and image #20.
.  Contrast: No contrast-enhancing lesions.

Ill-defined faint high T2 signal within the deep right frontal and periventricular white matter, without evidence of mass effect or enhancement. In retrospect, this was likely present in 2015 but very difficult to see given the technique. Findings are abnormal but nonspecific, typically attributed to prior trauma/inflammation/infection, or chronic ischemia associated with migraine/atherosclerosis. Also consider demyelinating disease, although the findings are not pathognomic for multiple sclerosis.

Not sure what to think of this?  I haven't heard from the doctor yet.  And I have never had migraines, so I'm assuming that can be ruled out.
3 Responses
987762 tn?1331027953
It sounds like the radiologist is indicating what is better seen on your latest MRI is not new but was likely on your previous MRI a few years ago. The better technique this time around has made it slightly clearer, although keep in mind it's still only 'faint' with a better technique and it's not characteristic of MS ("not pathognomic") or in other words it's non specific.

The radiologist hasn't specified a number (or size) but points out it's clearer to see in 2 consecutive slides, honestly at a guess and mainly because of the singular wording he/she's been using, your MRI might of only picked up a faint foot print of 1 or 2 non specific <=3mm lesion(s) that might or might not of been there in 2015.

The frontal lobe is the largest of the four major lobes of the cerebral cortex and periventricular means situated or occurring around a ventricle, most common locations for T2 micro vascular lesions. From my understanding of migraine and common MRI findings with a migraine causation there's usually lots of tiny tiny microscopic lesions, often with references of focus, pop corn or clusters...  

Unfortunately or fortunately depending on how you look at it, your MRI doesn't seem to have come up with a suggestive-consistent answer to what might be causing your issues, the answer just might not be neurological in your neurologist opinion and if it isn't i'd advice you to ask if not neurological what else could it be...

Hope that helps....JJ  
Avatar universal
When I look back at the first MRI, it doesn't look like it was done with MS protocol.  I think that would be the technique difference.  

Also, how long are they supposed to wait after they inject the contrast?  They gave me the contrast and immediately started scanning.

I was also confused to whether there was one lesion or more than one by the wording.  But I have never had migraines.  I rarely even get a headache.  And from what I've been told, I would definitely know if I've had a migraine.  I really don't think that is a reasonable explanation.

One thing that does come to mind that I have been concerned with is Lyme disease.  I had a strange rash about 5 years ago and they tested me but it was negative.  I've read though that there can be false negatives.  So I'm going to see a doctor that specializes in Lyme to see what he thinks and get retested.

Right now I have not seen a neurologist this time.  I went to my PCP because the neurologist's office said it had been too long since I had been there.  I haven't heard from the PCP either.  It is Thanksgiving week here.  So I might not here anything till next week.

It is frustrating to still not have any type of answer.
I don't know off hand how long the wait after injecting the contrast is suppose to be, i don't think it's unusual for it to be straight away though. We did talk about the recommended wait time about 4-5 years ago, you could try to see if you can bring the old discussion up using the search this community, blue box at the top right of your screen.

Migraine was just one in the list of the common differentials mentioned, there are many different medical condition that are associated with micro vascular white matter lesions but with only 1 or 2 its even likely to be within normal findings.

I'm an Aussie so i really don't know very much about lyme disease, well nothing worth passing on that is...i'm not sure how active the Lyme community is now but it would probably be worth posting any questions you might have there too, hopefully someone will be able to let you know if what you've been experiencing could still be lyme even with negative test results.

Hope that helps......JJ
Avatar universal
The PCP recommended I go see the neurologist.  So I'll call Monday to see when I can get an appointment.
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