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Anthony Bray, MD
Anthony Bray, MD, Doctor
Category: Health
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Experience:  14 years as clinician in the field of Family Practice
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What are a few discrete T2 FLAIR HYPERINTENSE FOCI Where are

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What are a few discrete T2 FLAIR HYPERINTENSE FOCI?Where are the bilateral periventricular and subcortical white matter located?Since these T2 FLAIR are located in this region,what are the long term effects?
Submitted: 6 years ago.
Category: Health
Expert:  Anthony Bray, MD replied 6 years ago.



You need to follow up with a neurologist from the sounds of it. The abnormal MRI signals need to be interpreted. It sounds possibly consistent with multiple sclerosis. I don't have enough information to make any definite diagnosis but these are the type of findings that might be seen with MS. Further interpretation of the MRI images in the context of your symptom history is needed.


I hope this information helps. Further questions are welcome if you have any. If my answer has been helpful and to your satisfaction then please remember to press the "ACCEPT" button.Thank You and Best regards,


Anthony Bray MD

Customer: replied 6 years ago.

"there are a few discrete T2 FLAIR hyperintense foci in the bilateral periventricular and subcortical white matter consistent with microangiopathic changes."I just want an explanation of what this means!

Expert:  Anthony Bray, MD replied 6 years ago.

Hello again,


Well T2 is referring to the MRI magnetic frequency signals. They are done in 2 different frequencies referred to as T1 and T2. The FLAIR refers to another aspect of the imaging technique FLuid Attenuated Inverse Recovery. The technique information has more meaning to the radiologists that interpret the findings. MRI is magetic resonance. It has a pulsed magnetic signal and then listens to the echo that is given off from protons(hydrogen atoms) The hydrogen atoms are richer in certain tissue componants than in other ones. The hyperintense echo signal would be caused by a change that brought in more hydrogen atoms into the tissue such as edema or fluid into the tissue. An acute injury would do this for example. The ventricals are fluid filled structures in the center of the brain. Periventricul refers to the location of the structures and tissue adjacent to the ventricles. The cortex is the outer layer of the brain. The cortex is the network of brain cells where the most complex of the brains processing takes place. The subcortical white matter is where the area under the cortex has transmission fibers that are insulated with myelin. The myelin is an insulating material that wraps around transmission fibers within the brain. The cortex is grey matter and the subcortical region is white matter. The presence of the myelin is what makes this tissue white. Microangiopathic is referring to small blood vessels such as arterioles which are the smallest of blood vessels that precede the capillaries. So microangiopathic sounds that the changes found are injury spots due to mini-strokes. These are very small blood vessels that have closed off and caused VERY small strokes within the brain. These may be so small as to be asymptomatic or might have very subtle symptoms associated with them. Longstanding hypertension or high cholesterol might cause this problem to occur. You would likely be placed on aspirin daily as a preventive strategy to lower the risk of more of these typeevents and to lower the risk of a major stroke. The microangiopathic description leads away from a diagnosis of MS and more toward a vascular problem with the mini-strokes. These are probably only very small lesions about 1 mm in size (250mm =1 inch).


I hope this helps to clarify. I'll be glad to get back with you if you have further questions. Take Care and Best Wishes,


Anthony Bray MD

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