need some help deciphering some brain talk

[BrainAWOL]

Hi, my girlfriend recently received a letter that describes the results of her first and only MRI scan. We have sat an googled like you wouldn't believe but we are both having a little trouble understanding what it means and what implications the damage would have. If someone could help me decipher it would be a massive help! The letter was sent from one neuro. Ok, I will quote word on word what it says.

"An MRI scan of the brain at the time demonstrated 1 or 2 areas of periventricular hyper intensity adjacent to the right frontal and left atria of the lateral ventricle and a larger area medially within the left temporal lobe, and a focal area of hyper intensity within the body of the corpus callosum."

I have looked a little but am struggling to get a proper grasp of where the 'hyper intensity' is and what 'hyper intensity' means... if someone could please have a look and tell me where, what an what it do...

Thank you in advance.

[BobDAV]

Also, if you can think of the 'MRI' as sort of a cross between a good old X-ray & good old TV, a 'hyperintensity' means a 'bright spot'. The radiologist is pointing out a 'bright spot'. It can be caused by a lot of things (including but not limited to plaques, calcifications, scars, etc), which the radiologist won't necessarily get into. That's why it's important to go over it with the ordering physician to sort it out.

[BrainAWOL]

I should of explained sorry, That my girlfriend was diagnosed with Multiple Sclerosis. The MRI was done pre-diagnosis and even though that was 5 years ago, there hasn't been a follow up MRI. I was curious as to whether the hyperintensities were common in MS and what kind of symptoms were typical of plaques in these areas.

If there was damage to the blood vessels what would this indicate? I feel from your response that the damage isn't as extensive as to be able to directly diagnose MS and so this could be a good thing.

I understand the degenerative side of MS and so I am curious as to what would appear on a new MRI.


Thank you very much for your reply. I really appreciate your time.

[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.

First of all, why did your girlfriend have her “one and only” MRI scan? Secondly, did the radiologist give a differential in the report? These hyperintensities (or plaques) have a broad differential. 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. 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.

Other causes of plaques in the brain can be migraine. People with migraine often have plaques on their MRI that are of unclear cause or significance.

Other causes of plaques 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.

The different causes can be determined to some extent by interpretation of various sequences of the MRI. I highly suggest that your girlfriend follow up with the ordering physician. The MRI findings will need to be taken in the clinical context of why the test was performed.

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