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Dr. Chip
Dr. Chip, Doctor (MD)
Category: Health
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Experience:  Over 20 yrs of Family Practice
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Mri showed global cerebral volume fluid loss, found on mri-

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Mri showed global cerebral volume fluid loss, found on mri- what is this from? They said its mild. They are trying to decide whether or not i have ms or neurosarcoid. I also got into a major trauma accident and had 4 plates put in face 1 yr ago. This recent mri was done with contrast in hospital, i just saw the repor said that. I had mri of brain that didnt mention this 2 mo ago but it was not with contrast. What is your opinion?
Hi--sorry can you tell me exactly what the MRI report said--did you mean to say fluid loss or was it more a loss of brain mass? And why was the MRI done?
Customer: replied 4 years ago.
Do you remember me? Anxiety has decreased a bit... The mri report says:
There is mild global prominence of the cortical sulci and ventricles, suggesting mild global cerebral volume loss, as well as my white matter changes....
Sorry--you've got a new account so I can't see our previous conversations so I could recognize you. But with the term neurosarcoid I should have I guess. What was that about the white matter changes?
Customer: replied 4 years ago.
I have a new acct? Didnt mean to. It said the foci of t2 prolongation within deep hite matter of left frontal lobe appear stable. There is a t2 hyperintense focus within right frontal lobe. What do you think abt the fluid thing?
Well, the report doesn't say fluid loss--the term cerebral volume refers to the brain matter itself and not the cerebrospinal fluid in the ventricles and the sulci. Remind me what the previous MRI said
Customer: replied 4 years ago.
I dont have that report but it showed the 3 old lesions, not the hyperintense thing, and not the volume thing. But this is the first one with contrast i have had in years. So - what does the volume thing mean? Btw- i am transfering oct 15th from er to pre op and am pretty excited and think that will decrease my anxiety. Could my trauma accident have anything to do with this? I just dont understand what it means
OK--stick with me and forgive me if my memory doesn't serve but remind me about the accident
Customer: replied 4 years ago.
Ok- almost a year ago i had a trauma accident, atv rolled over my head/body 4-5 times down a hill, was in hosp for 2 week, fractured most of the rt side of my face (tri maellor -sp fx), i have 4 plates in rt side of face
Were you unconscious for any length of time? Brain ct or MRI at that time was normal--no bruising or hemorrhage?
Customer: replied 4 years ago.
No loc, ct scans of entire body- nothing was apparent in brain just major facial injury
OK So remind me--why the thought about neurosarcoid?
Customer: replied 4 years ago.
I have pulm sarcoid by dx. My neuro just says my lp which a few yrs ago igG synthesis is 19 and oligoclonal bands were 8- and he said that per my results it could be either by results and he said it is more likely to be one dx (sarcoid- neurosarcoid), he has never treated it so i dont want to start on all the meds he wants me to, so they are referring me to either usc or ucsf (they put in referrals for both and will see who ins approves.) back to the volume thing- what does that mean?
OK--sorry for needing the reminder. The basic idea here is that you've lost a bit of the brain mass or volume in the areas of the ventricles and the sulci--in a sense, the empty space has gotten larger. While that can be seen in older patients and in patients with previous head trauma, it can be from MS or neurosarcoid. I don't think we can chalk this up to your accident though. I think in your case the obvious choice here is the neurosarcoid given the other lesions and the increase in volume of the ventricles and the sulci
Customer: replied 4 years ago.
Is it serious? I know the diseases can be, but what exactly does this mean for me? They did say it was mild

Yes, it was mild and in any other context I might say it really is nonspecific and not to be concerned. It's just that on reason your doctor did the study was to differentiate betweeen possible MS and possible neurosarcoid. Still the diagnosis of neurosarcoid is difficult and I can't say you have it. Here's a link for you about the MRI findings--it's very technical but it does mention the cerebral atrophy/increase volume part.;year=2011;volume=1;issue=1;spage=15;epage=15;aulast=Ginat

Customer: replied 4 years ago.
For some reason i cant copy and paste that bc i am doing this from my phone... Is it serious? Does it continue to happen? Why did it not show on mri 1 month ago, maybe bc it was non contrast? Should this be giving me any symptoms??? Thanks in advance
No problem with going on as much as you need. Do you mean does the volume thing get worse?
Customer: replied 4 years ago.
No problems with goin on as much as i need?? Yes inam asking if it gets worse? Does it in itself cause any symptoms? And why did it show on the contrast mri and not the one a month ago? Its not acute right? Is it really subjective?
Well, there can be a lot of problems, some like MS with numbness and weakness of the arms and legs, headaches, but there can also be involvement of cranial nerves like the optic nerve or facial nerve, and if it involves the pituitary gland it can cause endocrine problems with thyroid, adrenal,and ovarian function.
Customer: replied 4 years ago.
But does the brain just continue to shrink? I know mostly what the diseases can do, i just dont understand completely about the volume thing, and why it didnt show up on my non contrast mri and how serious in itself- it is
No, it doesn't mean the brain continues to shrink and the mild volume change, like I said, may not be significant at all. And the reason it was picked up was because of the contrast--that allowed the radiologist to more precisely measure the volume change and since it took contrast to show it, it has to be mild.
Customer: replied 4 years ago.
Ok... So that is nothing to worry abt, i just need to get this ms/ neurosarc thing figured out...
I understand--trying my best to help here. Anything so far that's not clear?
Customer: replied 4 years ago.
Not really. Does the brain shrinking cause the headaches i get or is it generally symptomatic? Thanks
Well, the headaches could be from a variety of reasons even not related to any of this. The mild volume loss in general wouldn't cause any symptoms at all, certainly not headaches.
Customer: replied 4 years ago.
Ok- we- thank you for your help. Have a great night.
Please--keep in touch. I know how important this is for you and all I've been able to do is give you information here. Wish I could just give you a firm, direct answer but we're dealing with a difficult diagnosis, let alone what it might mean if it is the real diagnosis.
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