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New Term for 'Aging Brain' Lesions

I've gotten the report from my Hopkins MRIs last week. It's surprising how little official information is included---I can't find anywhere the notation  that these were done using a 3T scanner, but I was told a couple of times by the techs that they were.

Anyway, once again the radiololgist references my age. They found 'multifocal and confluent signal abnormality in the subcortical and periventricular zones. The corpus callosum is relatively spared....'  He calls it '...a distribution somewhat atypical for multiple sclerosis and most likely due, in a patient of this age, to leukoaraiosis. The lack of patchy signal abnormality in the corpus callosum, cervical spainal cord and infratentorial compartment is also somewhat unusual for multiple sclerosis, although it remains within the differential diagnosis for the visualized lesions. Other etiologies such as vasculitis could also be considered.'

So of course I looked up 'leukoaraiosis.'  It basically means aging brain.  Now all you young leukoaraiosis sufferers know what's wrong!  These are my first MRIs at Hopkins, so the radiology people had nothing for comparison, and also my first 3T MRIs. My neuro there had disagreed with past reports done elsewhere over several years which phrased it a different way---microvascular ischemic disease, which maybe is a worse form of aging brain, who knows. I don't know what he'll think after reviewing this report. I have the cd but can't figure out the software they used. It's very complicated to say the least. I wouldn't really try to interpret it anyway since I don't know what I'm doing in that regard. But since he leans towards lesion counting and this report does not name numbers, I'm puzzled.

My neuro also wanted to attribute my leg pain to diabetes, but once again the blood work shows that's not it. But he almost deliberately slanted it that way. It's not just my feet, and so on. He vacillated between probable MS and MS originally though it seems he's still convinced sufficiently. Fortunately he knows more about me than the radiologist does.

Well, I will start Avonex soon, once I hear from the nurse. Isn't this whole deal maddening?  And by the way, I don't have vasculitis!

ess
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147426 tn?1317265632
spell :((
Helpful - 0
147426 tn?1317265632
Well, it's an old term, but none of the doctors could pronounce it and the transcriptionists couldn't speel it.  So they use "age-related" now.
Helpful - 0
Avatar universal
Yes, I saw that. The site notes that PVL at least usually involves coginitive impairment, and thank God that one hasn't happened yet.

ess
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378497 tn?1232143585
Ess, that page describes periventricular leukoencephalopathy, which is supposed to be the same thing as leukoaraiosis. It's apparently also known as PVL. And you'll note that the microscopic analysis (histology) indicates that one cause of PVL/leukoaraiosis is demyelination. And there is a laundry list of known causes of leukoaraiosis (see below), not just "vascular problems." So just calling it leukoaraiosis doesn't seem to mean much since that appears to have many etiologies and is a relatively nonspecific MRI finding/description.

Bio

-----------------------
Non-arteriopathic causes of PVL/leukoaraiosis (note what's second on the list):

Alzheimer's disease
Multiple Sclerosis
Progressive multifocal leukoencephalopathy
HIV encephalitis
Creutzfeldt-Jakob disease
Postinfectious demyelination
Trauma
Radiation therapy
Chemotherapy
Treatment w Cyclosporine or other immunosuppressants
Post hypoxic ischemic encephalopathy
Hyperperfusion syndrome
Vitamin B12 deficiency
Fabry's disease
Proximal myotonic myopathy
Helpful - 0
Avatar universal
To all, thank you as ever for your kind support.

To Bio, I'm 64, apparently not too old for MS. And I found the web site you suggested and it's quite interesting. However, luckily I don't have the symptoms suggested for that malady.

To Elaine. What can I say? If Craig is willing to go through yet more testing and evaluation, and I can sure understand if he's not, Hopkins can't hurt. Maybe if he just takes the attifude of here goes nothing, or here goes only a big interruption in my day, he won't be disappointed if things don't turn out with a diagnosis. My neuro, at least, seems to be something of a lesion counter, but he does prescribe regardless. Would Craig be satisfied with that?

ess
Helpful - 0
220917 tn?1309784481
I just can't to this day believe he's not diagnosed.  I know you know that, because we speak about it a lot.  But to hear his report just irritates me.

Have a good weekend.  Try Hopkins!  Wait -- Think about it....

Z*
Helpful - 0
Avatar universal
Hi ess,
   Well, Craig's MRI from Hopkins also doesn't say 3T but he was assured it was the 3T machine.

His also says,"Multiple scattered T2 flair hyperintensity noted in the periventricular and subcortical white matter.  His also says there is a prominent T2 flair hyperintense lesion noted on axila slice 28 perpendicular to the body of the lateral ventricle in the left posterior parietal region.  

It also notes parenchymal  brain volume loss (brain atrophy).

Yes, the software for their cd's is harder to use than other institutions.  We went and got a copy of the actual MRI films to make it easier for other neuros to look at.

I wonder if Craig would get diagnosed at Hopkins????

I agree it is maddening.

Elaine
Helpful - 0
220917 tn?1309784481
Hey ~

I'm glad you finally got a 3T!  Just wish you had a better radiologist!  Aren't I so jaded?  

I just wonder what's with this guy/gal who sees these "patchy signal spots" or lesions in your subcortical and periventricular areas AND your cervical spinal cord, and wonders what kind of damage aging has done to you.  It boggles my long-in-the-tooth mind.

True, I don't have the learnin' this doc has had, and I'm not a'lookin' at the images, but from here, it looks like MS.  Especially given your history.  And I'm sure that's what your neuro will reckon.  He's put that together before, hasn't he?

I'm glad you'll begin with the Avonex soon!  And, like Deb said -- let's pray this is better than the Copaxone experience -- It just HAS to be!

And hopefully he will treat you for the leg pain, too.  How frustrating.  Is the Lyrica still helping, or has that peetered out?

Feel well,

*

Helpful - 0
378497 tn?1232143585
Also, it appears that MS itself can be causative for leukoaraiosis, which is apparently a general term.

See this site:

w w w +dot neuroland +******* followed by cvd then a / then perven_leuko +dot htm.

I've pasted it below, too, but since Medline fritzes these out, I've described it above.
neuroland.com/cvd/perven_leuko.htm

Bio
Helpful - 0
378497 tn?1232143585
Ess, I'm sorry I don't remember, but how old ARE you?

Bio
Helpful - 0
429700 tn?1308007823
That is crazy!  I wonder why radiologist make statements like that, without having the bigger picture.  I'm so glad that you'll still be getting treatment for the MS.  I hope you do better on Avonex than on Copaxone.  

Deb
Helpful - 0
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