headache, neck pain and left arm numbness

[paramedic]

Can anyone tell me if these MRI results explain my daily migraine headaches and left arm numbness.

  
MRI BRAIN W/O CONTRAST

DOB 6/1 9/1951


Results
MRI OF THE BRAIN

BRIEF HISTORY:
Patient with headache, neck pain and left arm numbness.

TECHNIQUE:
A multiplanar, multi-sequential MRI of the brain was obtained without      IV contrast.

FINDING:
The patient demonstrates multiple areas of T2 hyperintensities scattered throughout both hemispheres, particularly in the periventricular area. At the same timed there is a rounded shaped lesion in the left Centrum semiovale that measures about       4.5 mm x 5.2 mm in diameter. At the same time, there are multiple smaller hyperintensities in the bilateral Centrum semiovale as well as some of them in the occipital lobes as well.
On sagittal FLAIR sequences the patient also demonstrates multiple T2 hyperintensities. Some of them are perpendicular to the carpus callosum. At the same time there in increased signal noted in the base of the corpus callosum and some of them in the body of the corpus callosum as well.

Though these are quite nonspecific findings but considering this age groups obviously the first thing would be to consider is demyelinating disease like MS.
At the same time Sarcoid, Lyme, Vasculitis as well as small vessel disease are also in the differential.

Patients with chronic migraine also tend to have these lesions as well.

None of these findings are present on diffusion weighted sequence to be suggestive of acute stroke Normal flow void noted in major cerebral vessels.

There is slight increased mucosal thickening noted in both maxillary sinuses. Visualized portion of the orbit seems to be normal but right eye does seem to be slightly deviated to the right though it could be an exotropia but at the same time could be positional as well. An incidental note Is made of hyperintensity in the right parietal lobe measuring about  11 x 6 x 7.0 mm in diameter, most likely represents sebaceous cyst.

IMPRESSION:
1. Multiple areas ofT2 hyperintensities throughout both hemispheres, consistent with white matter abnormalities. See above fed detailed description.
2. No evidence of acute stroke on diffusion weighted images.
3. Incidental sebaceous cyst in the right parental lobe.

[artha]

I was just wondering if you ever got a diagnosis or resolve on your results.  I just got almost an identical result from an MRI I got last week.  Many thanks

[dr_simran]

Hello paramedic,

Multiple sclerosis can be difficult to diagnose since its signs and symptoms may be similar to many other medical problems
Multiple sclerosis (abbreviated MS, also known as disseminated sclerosis or encephalomyelitis disseminata) is an autoimmune condition in which the immune system attacks the central nervous system (CNS), leading to demyelination. For a more clear evaluation, Most commonly used disnostic tools are neuroimaging, analysis of cerebrospinal fluid and evoked potentials. Magnetic resonance imaging of the brain and spine shows areas of demyelination (lesions or plaques). Gadolinium can be administered intravenously as a contrast to highlight active plaques and, by elimination, demonstrate the existence of historical lesions not associated with symptoms at the moment of the evaluation. cerebrospinal fluid is tested for oligoclonal bands, which are an inflammation marker found in 75% to 85% of people with MS.

Although there is no known cure for multiple sclerosis, several therapies have proven helpful. The primary aims of therapy are returning function after an attack, preventing new attacks, and preventing disability. As with any medical treatment, medications used in the management of MS have several adverse effects. At the same time different alternative treatments are pursued by some patients, despite the paucity of supporting, comparable, replicated scientific study.


This information would give you more clarity.

Refer: http://en.wikipedia.org/wiki/Multiple_sclerosis

Best