Leukoariosis

[katsu3011]

My grandpa had a frequently headache. We brought him to have MRI.
And the MRI report show following impression:
1. Finding are suggestive of a tumour in the right Meckel's cave with infiltration of the adjacent medical temporal lobe and pterygoid process. Differential diagnosis includes NPC and lymphoma.
2. Small vessel microangiopathy disease (leukoariosis).
Findings:
an enhancing lesion is noted in the right Meckel's cave and adjacent medical temporal lobe as well we infiltration into the right pterygoid plate.

He is 80 years old. Doctor had gave him some medicine, but after he applied the medicine, the headache does not reduce but he feel dizzy. Would appreciate your advise on what is this disease, and what is the cause.

[Dr. A. Srivastava]

Thank you for your question. His reports suggest that he certainly has a tumor in brain and Leukoariosis (white brain disease or microangiopathy disease) that should be correlated clinically with his symptoms like trigeminal neuralgia. Please consult a neurologist in this regards. Hope this helps.

[katsu3011]

Following are the detailed MRI reports:
Radiology report:
MRI Brain
Clinical Indication: Right trigeminal neuralgia

Finding
an enhancing lesion is noted in the right Meckel's cave and adjacent medical temporal lobe as well we infiltration into the right pterygoid plate.
The right orbital region and right cavernous sinus apprear normal.
no mass or abnormal enhancement noted in the postnasal space.
The canernous portion of the right ICA demonstrates normal flow void.
No other focal enhancing lesion seen.
Multiple small non enhancing periventricular hyperintensities are noted on FLAIR and T2 in keeping with small vessel microangiopathy disease. No restricted diffusion.
Sulci and basal cisterns are prominent consistent with generalised cerebral atrophy.
Incident cavum septae pellucidi with vergae noted.
Visualised paranasal sinuses and mastoid air cells are clear.

Impression
1. Finding are suggestive of a tumour in the right Meckel's cave with infiltration of the adjacent medical temporal lobe and pterygoid process. Differential diagnosis includes NPC and lymphoma.
2. Small vessel microangiopathy disease (leukoariosis).

I hope that it help...

Thank you very much

[Dr. A. Srivastava]

Thank you for your question. Although without being able to placing your findings in context with clinical features and the results of other investigation such as hematological, MRI, I can not offer the specific advice & treatment he needs. However, I will try to provide you some relevant information about his health concern.

Leukoariosis is also known as white matter disease of brain and there can be many possibilities in his case that involve the brain white matter, either exclusively or in combination with grey matter changes. These include metabolism errors, exogenous toxins released by virus, autoimmune disease, leukodystrophy, demyelination, and radiation effects. Spasticity, muscle weakness, paralysis, dizziness, headache, hyper-reflexia and movement disorder may be the clinical features associated with white matter disease that need to be evaluated thoroughly. However, it is sad to say that there is no permanent cure but conservative treatment & physiotherapy exercises that would help him to regain his normal function and stopping the further progression of the disease. Please consult a neurologist in this regards. Hope this helps.