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Dr. Mark
Dr. Mark, Doctor (MD)
Category: Health
Satisfied Customers: 11946
Experience:  U.S. Physician/Surgeon in Neurosurgery
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A tiny focus of increased signal is noted within the left side

Resolved Question:

A tiny focus of increased signal is noted within the left side of the midbrain, just to the left of the midline.Whilst this is non specific it is most likely related to small vessel ischaemic disease. what does this mean?
Submitted: 7 years ago.
Category: Health
Expert:  Dr. Mark replied 7 years ago.
Do you know where in the brain you had this "small stroke"?
Customer: replied 7 years ago.
No i dont - they could find nothing significant.
there was nothing significant on the MRI. there was multiple scattered foci of signal abnormality within the deep white matter of both frontal lobes
the stroke made me paraylised on the left side for about 1 1/2 hours and then i have had a weakness on the left side ever since - about 6 weeks
Expert:  Dr. Mark replied 7 years ago.
OK.

When the radiologist says there is a tiny focus of increased signal -- they are just saying that on the MRI picture, the area in the midbrain looks a bit "whiter" than the surrounding brain. The word tiny is important, meaning this is a very small area, and unlikely to be significant.

They go on to say this is possibly small vessel ischemic disease -- or changes in the small arteries in the brain that can cause small areas of changes in the brain -- similar to the "multiple scattered foci of signal abnormality within the deep white matter". These are changes in the brain that can occur due to years of high blood pressure, smoking, high cholesterol, etc.

These are changes that are not usually significant, nor do they explain your symptoms.
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Customer: replied 7 years ago.
you say these are changes " due to years of high blood pressure, smoking, high cholesterol, etc." but i have never had any of these conditions
Expert:  Dr. Mark replied 7 years ago.
OK.

Those are only some of the conditions that can cause those changes.

The fact that you have other locations of these changes within the frontal lobes makes me think that this specific thing they see in the midbrain is likely of the same issue, and not signficant.
Customer: replied 7 years ago.
i guess what i really want to know is what has caused the small vessel ischaemic disease when i have none of the conditions leading to tit
Expert:  Dr. Mark replied 7 years ago.
There are many reasons that can cause this.

Previous head injury, previous stroke, migraines, an inflammatory disorder, and even just normal vascular spaces can be the cause of these small hyperintensities.

They do not have to be the small vessel ischaemic disease. That is simply one possible cause.