MRI and short term memory loss

[Addie2U]

I finally obtained a copy of my MRI report as well as the CD with the actual pics of the MRI (like I could really understand what I was looking at).  Anyway, after a lot of blah, blah, blah that I don't understand and that was stated as unremarkable, which is a good thing, these are the things that stood out:

HISTORY:  56 yr old female w/short term memory loss, personality changes; tonic clonic idiopathic seizures; seizure free since 1989.

  A focus of increased FLAIR and T2 signal is appreciated in the left perifrontal/periventricular white matter measuring approximately 7.5 millimeters in it's maximum dimension.  Smaller lesions are seen in the anterior aspect of the left corona radiata subcortical white matter of the left frontal lobe.

There is subtle mucosal thickening in the frontal, sphenoid, bilateral ethmoid and maxillary sinuses.  Mucous retention cyst is present in the right maxillary sinus measuring at least 1.2 cm.  

IMPRESSION:  
Abnormal signal foci in the perventricular/perifrontal white matter, anterior corona radiata and subcortical white matter of the frontal lobe on the left w/out associated mass effect or retractive changes consistent with probable nonspecific demyelination or gliosis.  A contrast enhanced MRI of the brain, however, is recommended for further evaluation.

Basically, I have the neurologist from h*ll.  He told me these spots were indicative of migraines, high blood pressure or diabetes - I have none of those.  Since he brushes off any questions I might have, could someone please explain to me what the above means.  I understand the chronic pansinusitis . . . but I don't understand the other, and I don't think it's helpful to me to google certain words to come up with what it says.

Please!  Any help someone could give me would be much appreciated.

[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.  

There are multiple causes for white matter signal changes on MRI. Most often, these are due to what is called "chronic small vessel disease", literally meaning diseased small vessels that supply blood flow to the brain, as your neurologist was indicating. This is not an uncommon process in the brain and increases with age. This is not a disease in and of itself but rather is a reflection of unhealthy blood vessels, damaged by years of plaque build-up. This is most often due to a combination of several factors including the following: high blood pressure, diabetes, smoking, and high cholesterol. If these factors are well controlled, the damage to the brain can be stabilized and further damage prevented. I understand that you do not have migraines, HTN, or DM. Other causes can

Other causes of white matter changes on MRI can usually be distinguished based on history and symptoms, such as symptoms of neurologic deficit (for example arm weakness or difficulty walking etc). These can also be distinguished based on the MRI appearance. These include, but are not limited to, multiple sclerosis, other demyelinating disease, and inflammatory processes such as vasculitis.

I would continue discussing the results with your neurologist. It is difficult to provide you with more specific information given that we are unable to view images.

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

[ahameds100]

I've diagonised as follows in my MRI report.
MRI of the lumbar spine shows early spondylotic changes and disc dessication.
There are centrolateral disc protrusion at L4-L5, L5-S1 levels causing Right L5 and left S1 nerve root mild compression at the corresponding lateral recess level.
The rest of the finding are normal.

Could you please enlighten me on the seriousness of my above condition. Should I be in bed rest as suggest. Iam a frequent traveller due to professional demands.

[Addie2U]

Thanks again

[Addie2U]

Dr. Newey -

Thanks for your comments.  Since I submitted my question, my doc has informed me I had a homocysteine of 26.2 (grandfather dropped dead of a heart attack when he was my age), and my B12 is borderline.  Other than Vitamin D coming back low and Alkaline Phosphatase coming back high . . . my blood work looks really good (except for those three tests).

Could the homo level be indicative of artheroscolrosis (sp?), especially with a borderline B12???

And was the radiologist's comments regarding doing an MRI w/contrast because he doesn't know the person/history . . . and my doc ignored it, 'cause he does?