Avatar universal

What is FLAIR signal hyperintensity

After experiencing some minor numbness on my left side, I had 2 MRI on my head and brain.  The report I received says, in part:

"Several sulci of T2 and FLAIR hyperintensity within the white matter of both cerebral hemispheres"  "Primary diferential considerations include sequela of chronic small-vessel ischemic disease.  No evidence of acute infarction."

My Intenet searches have turned up a plethora of discussions of FLAIR hyperintensity in connection with conditions that range from Lyme disease to MS, but I haven't found a specific explanation of T2, FLAIR, or hyperintensity as they apply in this context.

Can you give me a fairly complete explanation of the terms and the significance of the phrase "sulci of T2 and FLAIR hyperintensity within the white matter" as well as any other insight into what this finding implies?
80 Responses
147426 tn?1317265632
Hi, Welcome to the forum!

The wording in the MRI report is a little faulty, I suspect.  Sounds like the radiologist mispoke.  The first sentence would only make sense if the word "sulci" ( which is one of the deep fold that is seen on the outside of the brain) was actually meant to be the more common word "foci".  Then it would be stating that there were several "spot" of increased signal on the two imaging techniques.

These white matter lesions appear mostly to be the result of microvascular disease which is seen in normal aging (40"s +), migraines, hypertension, and possibly some of the clotting disorders which can result in tiny, ministroke events, (eg. Huges Syndrome)

Do you have a history of high BP or of migraines?  And how old are you?

For the "fairly" complete explanation (it needs some tweaking) please read our thread called "MRI, Lesions, and Symptoms."  There is a section in it explaining (in laymans terms) what the terms, T1, T2 and FLAIR mean.  I will find this thread and make sure it is on the first page, if you are viewing the forum by "Last post".  

Let us know if you don't find it.

Quix, MD
How do I get to this thread - I would love to read it!
Avatar universal
Thanks for the very clear response.

I am 67 years old.  I have "elevated" blood pressure or what is often called pre-hypertension, I believe.  My BP runs in the 145 to 150 over 78 to 82 range.

No migraines or or known clotting problems.

When I discussed the MRI with my internist, he pretty well blew it off, exept that he has scheduled a carotid scan at my request.

Avatar universal
I just finished reading my wifes MRI what follows is copied and pasted from the cd. The information is totally alien to me and I could you some insite... We will be speaking with her dr later this week.
Thank you for your time.
There are multiple foci of bright T-2 and FLAIR signal in
the periventricular white matter bilaterally. Several similar foci
are also noted in the brainstem and in the pons. These findings
suggest multiple sclerosis or vasculitis. There is no abnormal
enhancement. No mass or mass effect is present. There is no evidence of infarct or hemorrhage.
338416 tn?1420045702
Hi, joparo!

I recommend starting a new thread with this information.  What sort of questions do you have about this information?  Take a look at the Health Pages section (the link is in the upper right corner) for more information about a diagnosis of MS, and how to interpret your MRI.
Avatar universal
My child had a febrile seizure at 3 and a half years.last month when he is 5 and a half months,he had another seizure.The MRI brain and EEG have been reported to be normal.However today,another seizure took place.The MRI report states that:
"Evidence of a few discrete areas of T2 flair hyperintensity in billateral periventricular deep white matter"
IS there a need to worry?
AT the time of seizure the child has mild fever.Its been observed that on all occasions the seizures have occured after intense physical activities(exertion).
Please advice on d precautions as well as care to be taken while/post seizures

Thanking you
Yours truely
Avatar universal
MRI w/wo contrast reads: Patchy, rounded and punctate foci of increased T2 and FLAIR signal in the periventricular and deep cortical white matter.  A patchy focus of increased T2 and FLAIR signal is seen in the leftward pons as well.  These findings are non specific. Differential considerations include small vessel disease, gliosis, demyelinating pathology and Lyme Disease.
Past history of MS 40 + years ago.  At that time only one small patch was noted.  Repeat Lymes testing - negative.  Recent history of
diplopia and blurred vision.  Burning, numbness on left side of body.
Patchy focus on Pons could be correlated with diplopia.  Could other
findings be age related - age 61.  
What is involved with further investigation for potential MS diagnosis?
Waiting for your reply.          Pam Cress
Avatar universal
Hi could you please provide some insight as to what my recent MRI finding could mean:

"There are at least 20 T2 and FLAIR hyperintense FOCI within the periventicular and subcortical white matter of both cerebral hemispheres".

Also, I had a recent ANA test and the results were: Positive/Titre 80/patteren speckled.

Thanks.  Of note I've suffered migraines for 15 years.  I'm 50 years old.
147426 tn?1317265632
This forum does not have an official physician answering questions.  I am a physician here with MS, but I am not official and I was NOT a neurologist.

Unofficially, you have many lesions found with the T2 and FLAIR techniques in places that MS lesions are frequently found.  However, a long history of migraine disease can also cause this type of lesion, as can many other disease processes.

Why was the MRI ordered?  No one can even guess at what an MRI means without knowing what symptoms the person has and what abnormalities they might have on neurologic exam.

The positive ANA is very weakly positive.  At the titre of 1:80 it could well mean nothing.  Real autoimmune immune disease is typically associated with higher titers than that.

So, no one here can say what your MRI might mean.  Much more information is needed.  What kind of symptoms have you had and for how long?  Is MS suspected?

Avatar universal
Many thanks for your thoughts/input!  MRI was ordered for severe headaches.  I've suffered migraines for years.  My sister has similar ANA readings and had massive stroke at 43 yrs.

Again, many thanks!
147426 tn?1317265632
With a history like that of a family history of early severe stroke, you would need to be worked up for disorders of the clotting system like are seen in Hughes Syndrome, AntiPhospholipid Syndrome, etc.  This is very concerning.  Please make sure your doc or cardiologist sends the blood word for the blotting factors and the antibodies anti-pospholipid and antiCardiolipin, along with Factor Leiden V, etc.  There are more than those, but a good internist, neurologist or cardiologist would know the whole workup.

Avatar universal
Thanks!  Of interest I had DVT in my right leg (calf) at 25 years old!!   They never could determine why...they even though I had lupus.  Kind of makes sense looking back at things.

Best regards and many thanks for your thoughts on the matter.

Avatar universal

The MRI the study reveals tht there are small discrete T2/FLAIR hyperintensity seen in the basal ganglia capsular region , centrum semiovale and right frontal subcortical white matter
no midline shift see
note is made of panisinusitis

The physical symtom is left eye twitching.

Could you please suggest what is this and is this worrisome? Any suggestions?

Thank you in advance
Avatar universal

The MRI the study reveals tht there are small discrete T2/FLAIR hyperintensity seen in the basal ganglia capsular region , centrum semiovale and right frontal subcortical white matter
no midline shift see
note is made of panisinusitis

The physical symtom is left eye twitching.

Could you please suggest what is this and is this worrisome? Any suggestions?

Thank you in advance
Avatar universal
Please help!!! What are flair hypertensity? I have them within the subcortical white matter of the right frontal lobe with additional tiny focus also possibly present within the subcortical white matter of the right centrum semi ovale. Aprox, 5 to 6 larger foci of FLAIR hyperintensity are demonstrated within the white matter posterior to he bodies of the lateral ventricles bilaterally right more than left? Also in my MRI result, information states abnormal hypointensity to the calvarial osseous marrow signal. I also have Chiari Malformation (this i already know much about). I am just not sure what the other indications mean??? I am only 24 years old!

Read more: http://www.justanswer.com/questions/2aez6-a-few-scattered-foci-of-t2-flair-hyperintensity-are-present#ixzz0aIOpxgXJ
Avatar universal
my wife mri of brain reveals a few discrete and punctate t2w flair hyperintense foci scattered in the bilateral periventricular sub cortical and deep white matter in temporal-trigonal and frontal-parietal lobes ;non-specfic white matter hyperintensities (wmh) and common etiology include admixed perivascular(virchow-robin) spaces; et at cribleand prominent inferior vermian recess and cisterna magna with key-hole apperance with altered folia morphology of the vermian process;variant/dysplasia/d-w9dandy-walker-variant)
Avatar universal

I am a 37 year old woman and I had an MRI done about a week ago. I was refer to the Neurologist. My MRI results were several punctate foci of T2 and flair signal hyperintensity within the subcortical white matter of the frontal lobes. Primary differential considerations include sequela of previous infection or trauma, sequela migraine headaches or sequela of minimal chronic small vessel ischemic. I never suffer from headaches I am a bit concern because i been having muscle aches and it is difficult to walk, dizziness and some blurry vision, lossing concentration and memory problems. My doctor explained me but I did not understand very well
Avatar universal
My brother MRI report says : "T2 and FLAIR hyperintense lesion noted in the left putamen and left centrum semiovale region suggestive of in fract"
Please help me to explain
Avatar universal
I was diagnose a year ago with MS and the findings of the MRI were:
Multiple deep hemispheric white matter T2 hyperintensities are present bilaterally. over 20 hyperintensities are identified.there is involmente of both subcortical and periventricular white matter.Lesions range in size from 3 mm to 12mm.A majority of these lesions do not demonsrate assocated T1 signal abnormality. A small area of decreased of T1 signal present in a left parietal T2 hyperintensity, consistent with significant underlying parenchymal danmage (black hole).
Please explain, I need to know to make a desition about changing or not my treatment

Avatar universal
Last November a nerve under my nose started twitching.  It twitched for about an hour and my nose dribbled for three days.  When the twitching stopped my skin around that area went semi numb.  That semi numbness spread to my whole body over the period of about a month.  The semi numbness is increasing in intensity.  My face is showing signs of drooping.  During this period my arms and legs have ached for weeks at a time.  A lot of the time my body has felt like its being microwaved i.e. like every cell in my flesh is vibrating at high speed. My MRI shows non specific T2 hyperintense foci in the subcortical white matter and one non specific hyperintense focus in the right frontal periventricular white matter region.  There is no evidence of any typical demyelination plaques.  The corpus callosum is normal in signal intensity, contour and morphology.  There is no obvious lesion in the cerebellar peduncles or in the posterior fossa.  The ventricular system and basal cisterns are within normal limits.  The brain stem and posterior fossa structures are within normal limits.  Can anyone help please?
1281753 tn?1271374877
my MRI W/O contrast, (as I have a severe reaction to the contrast as in, my entire right side, became cramped, my thumb locked to the palm of my hand, my fingers locked and started twisting in a different direction,then my wrest, elbow, and I yanked the IV out before it hit my shoulder. (while burning to the point it felt as though I had a blow torch on my arm, from the finger tips to the arm pit, along with my arm became bright red, and my hand where the IV was inserted had turned bright white, almost light green, the look of a dead body part, the tech, said in 20 yrs. she had never seen that reaction before!) my MRI report states, right frontal deep white matter 5mm punctate focus of T2 and FLAIR weighted hyperintense signal. the brain parenchyma "otherwise" appears normal. There is mild right "Mastoid Air Cell disease. IMPRESSION: There are few bilateral cerebral white matter punctate foci of T2 and FLAIR weighted hyperintense signal. The appearance in "nonspecific".
Could a 25 year old brain injury, cause these abnormalities. My medical insurance is far from great, not even close to good, I feel as though I am being put on the back burner so to speak. The neurologist, has no desire to find out WHY! Can any one out there give me some feed back? Please, and THANK-YOU
1352008 tn?1278514357
Small focal hyperintense T2 signal demonstrated at the deep right parietal lobe white matter.
1396181 tn?1280367311
My MRI states, "There is a tiny 4mm focal area of signal hyperintensity involving the pons just to the left of midline. This is seen on the T2 and FLAIR sequences, and actually shows slight enhancement with contrast as well. No additional foci are seen. this appearance is nonspecific potentially indicating a tiny area of demyelinization, nicroinfarction or even a very tiny neoplasm."

What does this mean?
147426 tn?1317265632
Hi, Janelle, and Welcome to our little haven of insanity.  Since you posted on an old thread and many people might not see your question, would you be willing to create a new discussion and tell us your story?  Why did they do an MRI in the first place?

What has been going on with you?

A lesion in the pons is quite significant.  What are your symptoms?

Just go to the green box at the top of the page "Post A Question", click it and write your story.  Then everyone will see you and can help answer you question.  It's easier to answer, though if we know more about you.

Avatar universal
Bedende zaman zaman baş dönmesi ve sağ tarafa doğru denge kaybı var ve bazen az da olsa uyuşma oluyor.
Çekilen Mr sonucunda

Sağda sentrum semiovale anteriorunda 3-4 .. çaplı istemik - gliotik olarak değerlendirilen bir adet T2-FLAIR sinyal hiperintensitesi izlenmektedir.
Vertebrobaziler sistem arterlerinde  hafif dolikoektazik seyir izlenmektedir.
Anterior ve posterior sirkülasyon arterleri SE sekanslarında normal signal void akım paterni sergilemektedir. Dural venöz sinüsler patent izlenmiştir.
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