MRI Results

I just thought I would let you all know that I probably have Multiple Sclerosis.  As background I had felt numbness of my face and hands, legs and other minor symptoms and looked up online what possibly might cause this and it looked a lot like MS to me.  I went to the doctor who didn't believe me but agreed to have me take a MRI.  I had the test last week and just got the results today.  My doctor did not know much about MRI readings and most of these words were foreign to her (like they are to me) but she said that they DID find damage to my brain and this was a very possible indication of MS. She has given me a referral to Neurology and I have an appointment scheduled on Nov 1st.  So I will get more information then. Here are the MRI results, most of the words are very big and I don't know what they all mean but I thought you might like to know. Basically they found damage in my brain and that multiple sclerosis is a very good candidate that caused it.


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Test Results:

Findings:

Multiple subcortical FLAIR white matter hyperintensities are noted bilaterally.  Scattered lesions are also identified within the corpus callosum and adjacent to the corpus callosum and periventricular white matter.  This is a nonspecific finding with differential to include primary demyelination, vasculitis, prior infections or inflammatory processes, ADEM or prior trauma.  There is otherwise normal signal, size and configuration throughout the brain parenchyma and the CSF-containing spaces.  Grey and white matter differentiation is normal.  There is no infarct, hemorrhage, mass-effect, hydrocephalus, space-occupying lesion, or pathologic fluid collection. Calvarial bone marrow signal is normal.

Circumferential and polypoid mucosal thickening is noted in the right maxillary sinus.  The mastoid air cells are clear.  Orbits are normal.

IMPRESSION: Multiple subcortical and periventricular white matter FLAIR hyperintensities including lesions involve corpus callosum are a nonspecific finding with a broad differential as described above. Given the clinical history, a primary demyelination process is suspected. Neurology consultation is advised.

End of medical report.
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This is not my brain.  I just found it on the internet and I thought it was a good representation of MS

My research on the MRI results.

Wording in the MRI report

1)     Multiple subcortical FLAIR white matter hyperintensities are noted bilaterally. 

2)     Scattered lesions are also identified:

a.     Within the corpus callosum and  adjacent to the corpus callosum

b.     Periventricular white matter.

3)     Given the clinical history, a primary demyelination process is suspected.

My research and interpretation of the MRI report:

1.  subcortical structures of the brain - It mainly control the linguistic part of the brain, damage to subcortical circuits results in permanent language deficits. Speech, lexical access, the comprehension of meaning conveyed by sentences, and various aspects of 'high' cognition are regulated by parallel circuits that involve the basal ganglia and other subcortical structures, as well as neocortical structures.

                  Bilaterally- both sides of the brain

                  Hyperintensities refer to areas of high intensity on particular types of magnetic resonance imaging (MRI) scans of the human brain. These small regions of high intensity are observed on T2 weighted MRI images (typically created using 3D FLAIR) within cerebral white matter (white matter hyperintensities or WMH) or subcortical gray matter (gray matter hyperintensities or GMH). They are usually seen in normal aging but also in a number of neurological disorders and psychiatric illnesses.

2.               a. Corpus Callosum a wide, flat bundle of neural fibers beneath the cortex in the eutherian brain at the longitudinal fissure. It connects the left and right cerebral hemispheres and facilitates interhemispheric communication. It is the largest white matter structure in the brain, consisting of 200–250 million contralateral axonal projections.

While lesions in the corpus callosum are especially seen with MS they are NOT seen exclusively in MS. This is where the clinical context is very important, because the other potential causes of lesions in that location might have very different clinical presentations from MS. If the history and exam are suggestive of MS, then lesions in the spinal cord and multiple brain areas as well as the corpus callosum would be very suggestive of MS.

If the history suggests a single event (or no actual event of symptoms) then one alternative explanation might be a single "event" of demyelination involving multiple parts of the central nervous system. This is called a "clinically isolated demyelinative syndrome". Many (but not all) patients with this condition do turn into MS later. Migraine does not cause lesions in the corpus callosum, but (rarely) other conditions might do so. Most of these (e.g. tumors, infections, etc) would appear clinically distinct from MS and would not be a cause of confusion about the diagnosis

 b: Scattered lesions are also identified in Periventricular white matter

Periventricular white matter (PVWM) is a type of brain matter comprised of nerve fibers that generate nerve impulses at a fast rate. It is positioned along the side of the brain's lateral ventricles. Periventricular white matter plays an important role within the central nervous system and is largely responsible for the actions of the body's muscles.

The nerve fibers that make up periventricular white matter are axons, which are long, thin extensions of nerve cells. The axons are covered with a sheath of electrical insulation called myelin. Myelin serves to amplify the speed of nerve impulses within the brain.

Periventricular white matter has two primary duties. It functions as a connecting unit between areas of grey matter within the brain. Grey matter is another vital component of the central nervous system and consists largely of neural cell bodies, which are important to the production of nerve impulses. Periventricular white matter also transports impulses between neurons.

There are three different types of channels periventricular white matter utilizes to transmit impulses; these channels are called tracts. Projection tracts direct messages from the cortex to other areas of the brain, from the brain to the muscles, or into the brain via sense receptors. Commissural tracts conduct messages between the left and right hemispheres of the brain. Within one hemisphere of the brain, messages travel through association tracts.

Periventricular white matter, sometimes referred to by the acronym PVWM, is usually white, off-white, or light pink in color. The pink color is present because of the capillary veins in the lipid tissues that make up myelin. Grey matter, despite its name, is also pink, though typically of a noticeably darker shade.

Changes in PVWM are common throughout the aging process. The slowing of motor speed is a natural consequence of growing older. But changes in PVWM can sometimes be caused by a more serious medical problem. A specific type of dementia called Binswanger's disease, migraine, and stroke have all been shown to induce radical changes in PVWM. When plaque builds up in PVWM, Alzheimer's disease may result.

By far the most prevalent condition to affect PVWM is multiple sclerosis. In patients with MS, the myelin sheathed around the axons of PVWM slowly denigrate due to inflammation. The extent of PVWM damage can be gauged by a form of imaging technology called diffusion tensor imaging, which provides a detailed look at the white matter areas of the brain

3.  A demyelinating disease is any condition that results in damage to the protective covering (myelin sheath) that surrounds nerve fibers in your brain and spinal cord. When the myelin sheath is damaged, nerve impulses slow or even stop, causing neurological problems.

Multiple sclerosis
Multiple sclerosis (MS) is the most common demyelinating disease. In this disorder, your immune system attacks the myelin sheath or the cells that produce and maintain it. This causes inflammation and injury to the sheath and ultimately to the nerve fibers that it surrounds, and may result in multiple areas of scarring (sclerosis).

Other causes
Other types of demyelinating disease and their causes include:

·       Optic neuritis — inflammation of the optic nerve in one or both eyes

·       Devic disease (neuromyelitis optica) — inflammation of the optic nerve and spinal cord

·       Transverse myelitis — inflammation of the spinal cord

·       Acute disseminated encephalomyelitis — inflammation of the brain and spinal cord

·       Adrenoleukodystrophy and adrenomyeloneuropathy — rare, inherited metabolic disorders

MS and other demyelinating diseases may result in vision or hearing loss, headache, seizures, muscle spasms and weakness, loss of coordination, paralysis, and loss of sensation.