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Jack Scariano Jr
Jack Scariano Jr, Neurologist (MD)
Category: Neurology
Satisfied Customers: 1057
Experience:  Board Certified Neurology 1982 30 years experince. Also expert in Pain Medicine
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IMPRESSION: Minimal area of right posterior frontal lobe subcortical white matter microvascular ischemic gliosis. The brain MRI is otherwise normal.
FINDINGS: a few sentences about normal and then…. “Focal area of microvascular ischemic gliosis in the right posterior frontal lobes, subcortical white matter is somewhite subtle, 5 to 6mm. This is unchanged………..No intrinsic abnormalitiy in the brainstem or cerebellum, and there is Chiari malformation.

Am wondering if the very last phrase about the Chiari malformation is typ b/c my doctor said all ok.???

What you have on he MRI is a very common finding on brain MRI.this is most commonly see in patients over 40 and can be assosciated with mild cerebovasular disease if you have have risk factors. Some risk factors include high blood pressure, family histoy of stroke ot heart attack, smoking,migraine, previous head trauma and diabetes. However 50% of the lesions have a unknown cause and may even be congenital or developmental.


The most recent previos Mri as requested to see if there were any new lesions present from the previous one. This would indicated that new lesions were being acquired probably from the vasular etiology mentioned above.. The above are the known causes but when seen, they are nonspecific other then the vasular associatian previous mentioned, and there is no way to sort out the possible causes from the unkown by MRI.


Thay are not associated with brain tumors, MS, alzehemiers disease, ALS or any ther chronic or acute Neurological disease.


The Chari is a normal varient unless there is more than a 5 mm protrussion into the upper cervical spine. It is seen in 5-10 % of al patients on a MRI. There is no specific treatment unless in is very large.


Hope this helps< DR S.




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Customer: replied 5 years ago.
yes, that does help, particularly the statistics showing how commong the findings are, the citesI looked at (Mayo, NIH & such) did not mention the frequency over 40. That would have made a big difference in understanding why my doctors are not exploring it, also why they are exploring most recent (2008) instead of least recent (2005)which found the most abnormalities. you explain very well for patients to follow, and yet don't simpify so much we are clueless. I appreciate that, I think we all do, though it is hard to retain, which is what makes this kind of written exchange so valuable. I can re-read it, and get the spelling right (or much closer than if I, or someone I took with me were tring to capture in a in person appt). thanks again for reeling in my question and giving me something to go on!
Customer: replied 5 years ago.
feedback on recent brain MRI following memory loss/stroke

lost you off my question "waiting" didn't know if you didn't want to reply, weren't available or if it got otherwise snagged, but would love to hear what YOU have to say if you would like to weigh in. I haven't been on laptop much, my close friend and husband been handling accounts and such for me, have never needed so much help to function at such a minimal level. But I am still functioning!!!

CHIARI MALFORMATION in recent BRAIN MRI but Primary said everything is Ok, is it a typo, or was she so relieved not to see signs of stroke she missed it? I am being treated by Pain Specialists (and many specialists) since late summer for excruiating pain due to cervical spinal stenosis, multiple disk degeneration, including disk extrusion at c7, the MRI was follow an MRI were I lost memory. I have Hx of Factor V Leiden, Antiphospholipid and TIA. The pain is so severe with the neuropathy/cervical radiculopathy I am being treated by cancer pain specialist. I have many balance issues, took bad fall couple weeks ago. Have trouble with speech and increasing trouble with memory and speech that mostly my husband seems to notice, medical providers have not said they notice.

it was a week today since MRI and I just noticed the Chiari Malformation and started reading about it, thinking I should go see my primary and make sure there is not a typo, and if not, why were are not talking about given so many of my symptoms seem to coincide with this conditions.

Appreciate any important because this new painful condition, assumed to be the disk extrusion, has taken over my life, or most of it, my social life, every part of it. I am not able to drive. I never know when I am going to make involuntary gasps in pain (quite in embarassing). Now trying many meds with many side effects that keep me close to home.

insights appreciated, as always


Optional Information:
Gender: Female
Age: 52

Already Tried:
2 Pain and Rehabil Med Specialist Anethesiologist (epidurals - 2) Nurse Anesthetist (27 "nerve blocks/trigger point injections) Physical Therapy' Mediation, Relaxation breathing exercises, self hypnosis topicical treatments like lidoderm patches, hot baths, moist heat pads, hot baths, icing (20 min on, 20 off). massage, prayer

Customer: replied 5 years ago.
sorry about the confusion, there was a neurologist that exchanged about 50 replies since sept on my case, but I guess he is not taking questions right now because it went you. Ah well. I just figured he had so much back story. Sorry for the confusion. I do have my quesiton answered and I do thank you.
goood luck
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