MRI questions

[scoderoni]

Let me start by giving a bit of medical history... About 9 years ago I had trouble with blurry vision, fatigue and weakness in my hands. MS was suspected at that time because of some white matter lesions on my MRI. Had to have a lumbar puncture which showed nothing, so once my symptoms went away in a few months nothing more was said or done about it. Since I had no symptoms I kind of just put it away and forgot about it.

Five weeks ago I was incredibly fatigued and slept for the better part of 24 hours... Woke up at 7 in the evening when my husband came home and had trouble walking, extreme weakness in my right arm/hand and a little slurred speech. He look me to the ER and I was admitted, at the time they suspected a stroke. After one day I was feeling better, the only symptom remaining was the arm/hand weakness. They CT scan they did showed "something" in the basil ganglia area... Was put on daily aspirin.

Went to my regular doctor a few days later, informed her of my previous tests for MS, and she said that she was starting to suspect that as well... referred me to a neurologist who ordered an MRI...

Here are the MRI findings:  "On the FLAIR and t2-weighted sequences, there are multifocal areas of signal hyperintensity in the deep white matter of both hemispheres. Some of these appear to pericaliosal. They may represent old cerebral infarctions. The other possibility to consider would be that of demyelinating disease in the appropriate clinical context. No extra-axxial collections or midline displacement are seen. no areas of restricted diffusion seen on the DWI sequence. Normal flow voids for the major intracranial arteries are present at the skull base and in the posterior fossus. Minimal sinus disease seen in the right maxillary sinuses and the left eihmoid air cails. The mastoid air cails appear normally aerated."

The Impressions reads:  "Nonspecific white matter changes in both frontal lobes as described above, which would represent sequela from prior old infarctions versus manifestations of demyelinating disease. Lyme disease with the appropriate exposure would also need to be considered in the differential diagnosis. No abnormal enhancing lesions are seen. Minimal sinus disease. Examination of CSF may be of benefit if there is concern for wither Lyme disease or demyelinating process."

My main concern is if this could still have been a stroke or not. I'd also like to know if anyone can explain in more laymens terms what the findings say? Apparently my doctor's aren't concerned because neither of them have called since the MRI. I got the report from the nurse just by asking for it. I have no more DR appointments for 7 weeks, and I don;t want to wait that long...

[sllowe]

Hi there,

Welcome to the forum. I'm sorry for what you are going through. Your concerns are very very valid. If stroke, then what to do to prevent? If MS or a differential diagnosis, what to do to treat?

These wheels move mighty slow unfortunately. The doctor usually calls with findings, however, since you've only just begun the doctor may very well just wait until your appt. to further the investigation so he/she can speak to what may, or may not be going on.  

I venture to say, in laymens terms, your doctor will look into this further, order more tests and start to drill down on a potential cause.

In the meantime, rest when you can. We are here for you and understand that you'd like to know sooner than later. But, when you feel anxious to know, remember this....... It's very important for the doctor to get this right. You wouldn't want a rush weak determination based on minimal evidence. It's important to be treated for the right problem.

Hang in there best you can and thanks for joining us.
-shell

[SarahL2491]

well, you still can't get any "action" until you see the neuro again and he's the only one who can read it PROPERLY.  My experience is never trust the rad reading (which you have).  That said, here are some helps.  Did the rad have your old MRI to compare this one to?  That's often helpful.  You need to keep personal copies of the MRI disc and the reports, its something we recommend to anyone.

The ASA every day is a good thing.  I don't know how old you are but my cardiologist says everyone over 50 should be on ASA every day. I have heeded his warning and do so.

the rad is not ruling out MS, but he is suggesting an LP or a lumbar puncture.
If there are O bands in the spinal fluid, it helps with a DX.  But no O bands is common in many of us.  I have none.

It also sounds like you have a possible sinus infection or something causing this note.  It was how i found out I had a sinus infection!

If you are on an HMO, your present doctors have probably already chatted by report to each other, sharing what each found.

IF it was a stroke, it suggests an old one.  mini-strokes sometimes do not cause problems but may strike a lesion presentation.  Do you have a cardiologist or do a regular cardiac check up?  Another something I recommend to people.  (ya can't shut up those old nurses!)

If your doctor is very busy, he will wait and discuss it with you then.  IF he suspects MS, he will first order many blood tests to rule out things such as Lyme and other diseases.  Over 20-30 mimic MS with the same symptoms, including lesions on some of them.

You have 2 MRI's, so your neuro will compare them and decide what to do.
If it were urgent, he would have called and upped your appointment.

I know that probably isn't what you wanted to hear, but worrying won't help, you have to wait for the definitive answer and i will tell you that a DX for MS does not usually come in one visit, it takes quite awhile to put it together; some are lucky enough, many of us spend many years chasing it, only to realize its a club we don't want to belong to.

MS moves slowly for most of us, so no need to panic unless these attacks happen very often.  If you have another before your neuro appt, and go to the ER, have them call the neuro, he may put you on a steroid to ease you thru the attack.

Welocme to our group, its the week day and many members do not get to scroll thru the forum questions because they are at work.  There are some who can interpret this better than I.  Although I know you want answers, I do hope you do not have MS, it will follow you forever like a wicked stepchild you can't get rid of!  (meant to be funny to make you smile)  I will send you a PM about Lewiston, check your inbox