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911Doctor
911Doctor, Doctor
Category: Health
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Experience:  Board Certified Emergency Physician
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What does Multiple discrete foci of supratentorial T2 Hyperintensity

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What does Multiple discrete foci of supratentorial T2 Hyperintensity seen in subcortical and periventricular white matter . is this MS or Raynods Syndrome. if its one of them how does an MRI tell the difference .

911Doctor :

The MRI does not give the diagnosis though it may suggest one....

911Doctor :

Also, you have only provided a portion of the radiologists report and have not told me why you had the MRI in the first place... makes it nearly impossible to give a solid answerw

911Doctor :

'answer'

911Doctor :

that being said

911Doctor :

this is suggestive of MS as it stands

911Doctor :

Raynaud's phenomena is not a brain problem so I'm not sure who mentioned that....

911Doctor :

It is not diagnosed with an MRI of the brain

911Doctor :

perhaps you can tell me a bit about your symptoms?

Customer:

Sorry LOl , I had a spot 3 years ago on my Brain , they told me then with the weakness in my legs & dizziness , had a positive ANA that they couldn't tell me differently that it was lupus but that when during examination they noticed my feet color and stated raynods syndrome .

911Doctor :

and you may in fact have raynaud's, it can come with lupus, but that has nothing to do with your MRI results.....

911Doctor :

it's causes by spasm of the small blood vessels supplying the hands and feet

911Doctor :

that is Raynauds causes spasm to the small vessels supplying fingers/toes... it is a local pheneomena and not related to a brain problem

911Doctor :

sorry for the confusion

Customer:

Sorry 3 years ago I had a positive ANA had weakness in my legs & dizziness chest pain from time to time. During examination they noticed my feet had a blue color or something to them anyway, they said i cant tell you definitely its Lupus even though the fatigue the rash time from time on my neck etc. So the Dr. said i can tell you that you have Raynods Syndrome . I left it there . Its now 3 years later im having dizziness still memory loss subcantoues hemorrhages in my eyes ,migraine headaches, and weakness in my quads . Im a spin instructor i work out , but im short for breath and im feeling nasuish or throw up sometimes . My Ct scan of my Lungs is normal shows mild emphysema . I have to pee all the time 3 times a night no infection my eyeballs hurt & well you can say i had enough LOL . I made an appt for neurology tuesday but i already know what it is per say . My Mri report impression reads In association with Vasospastic phenomena which in other words i Know ! i use to be a medical assistant so i quess you understand LOL . I just need to know what your oppionun was even though i know

911Doctor :

well you may have microinfarctions due to the lupus.... this would cause small areas of

911Doctor :

stroke

911Doctor :

which might explain your symptoms... MS is till a possibility, depends very much on your sx plus the mri.

911Doctor :

standing by

Customer:

i thought that but the rhumotlogist told me no , no Lupus . My question how can he tell the difference between them is what im stumped with . Lupus , stroke , MS How do you doctors know

Customer:

I know many Bright regions on a scan can mask many things so how is Lupus stroke or MS defined

911Doctor :

stroke is not 'bright' on an MRI , MS lesions are typically 'bright'

911Doctor :

the pattern they make and the history of your disease is the other essential part

911Doctor :

if you have symptoms that come and go this argues for MS

Customer:

so then i have MS lesions on my report or i have Bright on what diagnose i gave you

911Doctor :

if you have progressive sx that do not remit

911Doctor :

then it is more likely that these are microinfarctions perhaps from lupus

911Doctor :

again, I can not say based on the report

911Doctor :

your case is not simple

Customer:

they don't come and go they are multiplying maybe some confusion in what im typing we started with vision loss then memory loss weakness, etc its only getting worse trust me not better i love to work out i can tell the weakness the headaches its not fun

911Doctor :

you have been told you have raynauds which often goes along with a connective tissue disease like lupus

911Doctor :

your symptoms seem to affecting multiple organ systems so this also argues for possibly lupus or another form of connective tissue disease

911Doctor :

MS is a neurological disease and certainly some of your symptoms could be from MS

911Doctor :

but not all

911Doctor :

that is why the neurology appointment will be so imporant

Customer:

i understand is a neurologist the best to see for this or should i be going back to rhemotolgy

911Doctor :

definitely the best to see you next...

Customer:

ok look thank you , for your opinion its always good to understand different factors . Have a great Weekend

911Doctor :

the neurologist will be very familiar with the neurological manifestations of diseases like lupus

911Doctor :

to this is a good thing indeed

911Doctor :

you too

911Doctor :

do you have any final questions for me?

Customer:

Thank you , NO I will do my best to understand whats going on . I thank you for your time Bye Bye

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