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Avatar universal

MRIs - What does this mean?

Lumbar MRI: "very mild disc bulge, congenital changes, mild ligamentum flavum hypertrophy and face osteoarthropathy with very mild central canal stenosis" in L4 - L5.

Brain MRI w/o contrast: "ill-defined increased FLAIR signal in the supratentorial brain bilaterally, including adjacent to the posterolateral aspect of the temporal horn of the left lateral ventricle as well as subcortical right front white matter. Findings are consistent with this representing a mild degree of nonspecific gliotic or less likely inflammatory white matter disease … the findings could represent an early or subtle demyelinating process, vasculitis, inflammatory or less likely other white matter process … Impression: nonspecific, chronic-appearing white matter disease."

I also had "probable hemangiomas" in my thoracic and cervical spine, which I was told are nothing to be concerned about. The reason the MRIs were ordered was because I had unexplained bladder problems the past year (now it has been two years). The neurologist said the findings on my brain MRI were insignificant and I had an EEG test that came back normal.

I have been having bladder problems (as well as other symptoms) for years and, after numerous tests, my urologist thinks it could be caused by something neurological.
20 Responses
1340994 tn?1374197577
It's supposed to be FACET, not face in the first paragraph.  

You have mild canal stenosis at L4-L5, which is the level that tends to affect the bladder and bowels as well as legs.  
Avatar universal
Speaking as someone who currently also has L4/L5 problems, may I suggest:

1. Make a list of ALL your symptoms; the duration of the systems (if you can) and WHEN they occur. For instance I have leg pain most of the day but it is SIGNIFICANTLY worse at night

2. After you make the list GO to a neurosurgeon  who specialises in the spine (or if you are sure NO surgery is needed then a neurologist) to look at the film WITHOUT you passing him/her the radiological report.

A good neuro can tell you what's the problem without being prompted by a radiological report by someone you never met who often is LESS experienced than the nerosurgeon.

Ask the neurosurgeon what he/she thinks is going on.
Avatar universal
Very mild disc bulge, cmon there is nothing that is minor when it comes to disc, that is what causing your bladder problem, I am not a doctor, but went through 7 back surgeries and still have problems. . Go to a spine laser surgery specialists, I went to a brain and spine surgeon, I am worse then when I started. Get a lot of opinions before surgery.  
Avatar universal
My earlier post read
"the duration of the systems"

but meant to say

"the duration of the symptoms"

I would go to another neurosurgeon for an opinion on the:

"I also had "probable hemangiomas" in my thoracic and cervical spine, which I was told are nothing to be concerned about. "

While a hemangioma is a benign tumor, it is worth finding out if the tumor is located in a place that may be a problem in time.

There is nothing minor about finding any tumor in a confined space. This is not to say that surgery is needed now or even at all BUT it means the matter must be invetstigated by a skilled neurosurgeon.
Avatar universal
Thanks, I'll look into how to treat that.
Avatar universal
I'm sorry to hear you are dealing with problems in that area as well. I was referred to a neurologist and he took one look at the report and said there was nothing wrong, so I'll try to get an appointment with a good neurosurgeon.
Avatar universal
That's crazy! I hope you're able to find some relief soon. I'll definitely take your advice and get lots of opinions in case someone suggests surgery.
Avatar universal
Okay, thanks! The neurologist I saw told me that a hemangioma is not a tumor - this was somewhat of a red flag to me because I had already done some research and knew that it was. I wasn't worried about it but I guess it's worth looking into with a neuro who knows what they're doing.
Avatar universal
Is it normal though, for me as a 20-year old female to have an abnormal brain MRI with a report that says it could represent a demyelinating process? Or could this have anything to do with a process that may be affecting my body and my bladder?
Avatar universal
I am informed that a"demyelinating disease" is a condition that results in damage to the protective covering that surrounds nerve fibers in the brain and spinal cord.

When this is damaged, nerve impulses slow or even stop, causing neurological problems.

I suggest that TODAY you arrange to see a highly regarded neurologist ideally associated with a high end medical centre to:

* confirm this is what you have AND
* if so, to advise you on how to deal with it. OR
* to advise what else may be going on.

When calling up to make the appointment say that you have been diagnosed with demyelinating disease and that you urgently seek an appointment.
Avatar universal
Hi Dear: I did not know you were 20 years old. You replied to my post which was very nice of you. I can give you the name of a Brain and Spine Specialist in West Islip. He  is the head surgeon in that office. His name is Dr. Kevin Mullins his # (631) 422-5371  and make sure you see him not one  of the associates. There are 5 Doctors in that office but he is the best. Good luck dear, hope everything works out. Will check in time to time to see how things are going.
Avatar universal
You mentioned bladder problems and that your urologist said it may be neurological. Did the urologist perform a cystoscopy on you? And if so, what were the results?
Avatar universal
While a cystoscopy may be worthwhile, it is interesting that you mentioned both bladder problem and L4/L5.

You should be aware that bladder an/or bowel problems are common with L3/L4 problems.

I urge you to have mri's shown to good neurosurgeons or neurologists. Never forget that the reports that come with the images from the imaging centre are written by (often) junior doctors who have LESS experience that very good neurosugeons.
Avatar universal
Thank you for the advice. I am supposed to see a top neurologist very soon so I'll see what he has to say!
Avatar universal
I appreciate the recommendation. I'm actually see a doctor at a top university pretty soon so I will see how that goes! I will definitely keep Dr. Mullins in mind, though.
Avatar universal
I have had two cystoscopies over the past couple years and his words the first time around were that my bladder was "anatomically perfect." The last one I had they found that I had a urethral stricture - although, even though that was treated I found it only made it easier to urinate and didn't help any of my other symptoms whatsoever. He said both times I had no inflammation or anything like that.
Avatar universal
when you see the neurologist do not show him the report you have that came with the images. After all, you want the neurologist/neurosugeon to express his own opinion and not parrot what someone else wrote.

Good news on the cystoscopy means the bladder is in the clear.
Avatar universal
Okay, thanks for your help!
Avatar universal
One more thing. Before ever going for a cystoscopy ask your family doctor if it is worth the trouble. This is because every invasive procedure carries risk, both from the anaesthesia and from the possible damage caused by snooping around with instruments inside your body.

For instance, last week I had a urine cytology. This involved giving urine over three days to test for cancer cells in the bladder. 2 of the 3 tests were good. One was so-so.

My family doctor said "rather than rush for a cystoscopy, wait 2 months and redo the cytology. If THEN you still get at least one so-so result only THEN consider having a cystoscopy done"

Of course my urologist wants the cystoscopy done asap.

I will wait.
Avatar universal
I'm sorry to hear that one of your tests didn't come back okay. I hope everything is resolved soon! Thanks for the advice, I'll definitely talk to my doctor about that.
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