Gliosis and MRI Test interpretation

[telusep]

I am a 51 wfm, and six month ago I was diagnosed a mini stroke.  I had an MRI in which a 1,5 mm aneurism was  found and no signs of lesions of any kind.
On a follow up MRI a week ago, it is said: "there is a punctiform, bi-cerebral hyperintensity in Flair T2,  basically in semi-oval center, further toward the peri-atrial region and peri-ventricular diffused bilateral.  The rest white and gray substance of good differentiation"  The conclusion states:  " 1.- Area of gliosis bicerebral supratentorial before mentioned, inespecific.  2.- Negative for hemorrhage and/or ischemia in the present study"
Two questions:  First, How come the first MRI shows an aneurism and the second does not. Second, what does  "Area of gliosis bicerebral supratentorial before mentioned, inespecific" mean?  
The tests were run in  different countries with different technologies; that might explain the difference in the conclusions of the tests.
In addition to the sypmtons of a mini-stroke, I have been sufferring from migraine since a teenager.

Thanks for your help.

Telma

[Christopher R Newey, DO]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with a doctor.

Without the ability to examine and obtain a history, I can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.

MRIs are subject to the strength of the magnet used to obtain. Also, MRIs obtain images at certain distances, for example 5mm. A small aneurysm may be missed if it is not included in the slice that is obtained on a repeat image. It would be important for you to have a follow up angiogram with either MR or CT.

Areas of gliosis on MRI can be from a prior infarct. Gliosis is an area of scar tissue.

If you have not done so, I suggest you follow up with a neurologist to understand why you had a stroke and what you need to do to prevent from a future stroke (such as blood pressure control, blood sugar control, taking an antiplatelet, determining the etiology of the stroke, etc).

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.