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DrBrain, Neurologist
Category: Neurology
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Experience:  Diplomate, American Board of Psychiatry & Neurology
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MRI report states: The ventricles, basilar cisterns, and cerebral

Resolved Question:

MRI report states: The ventricles, basilar cisterns, and cerebral sulci are mildly prominent. No masses, midline shift, hydrocephalus, extraaxial or intraxial fluid collections are noted. Extensive periventricular and subcortical white matter T2 hyperintense foci are noted, consistent with small-vessel ischemic disease. There are no regions of restricted diffusion. The visualized orbital structures, optic chiasm, pituitary, brainstem, corpus collosum and cerebellum are otherwise unremarkable. IMPRESSION: Mild cortical atrophic change without focal masses, acute infarcts or hemorrhage.

Patient is 83 yr old female. She had vitamin B12 and D deficiency, and has Mild Cognitive Impairment, dizziness and memory loss/lapses. Is this likely Alzheimer's, or possibly something else? Thank you.
Submitted: 2 years ago.
Category: Neurology
Expert:  DrBrain replied 2 years ago.

DrBrain : Hello welcome to just answer.
DrBrain : My views expressed are for educational purposes only.
DrBrain : Based on MRI results she has mild atophy whic is related to her age and it's normal. She has the white matter changes which according to her age is regarded as age appropriate.
DrBrain : Its not suggestive of Alzheimer's diseases.
DrBrain : Diagnosing Alzheimer's is based on clinical exam and not on MRI.
DrBrain : If you have no further questions then please press the accept button, Thank you.
Customer:

what about the prominent ventricles, etc ? she had clinical exam


 

DrBrain : Prominent ventricles would happen due to mild atrophy she has.
Customer:

Does memory structure appear intact, hippocampus, etc... can you tell from the report?


 

DrBrain : No the report doesn't report any area for hippocampus.
DrBrain : If it was abnormal they would haven wrtiten in the impression.
Customer:

Can you explain memory loss, any guesses please if not alzheimers.


 

Customer:

Do we have cause for concern, other than old age?


 

DrBrain : As person ages person may get dementia so if cognitive functioning has affected then it might be due to onset of dementia. Vitamin B12 deficiency can also cause deficiency.
DrBrain : Not likely any concern other than vitamin b12 deficiency and age is an important factor.
Customer:
DrBrain : Based on this MRI nothing is dangerous and findings are age appropriate.
Customer:

her doctor prescribed high dose b12 supplements and levels returned to normal.


 

DrBrain : Ok once the vitamin b12 is at normal level her cognitive skills would improve.
Customer:

small vessel ischemic disease is not too concerning?


 

Customer:

her shot term memory is almost gone, and her cognitive is poor.


any suggestions. I'm appreciative.

DrBrain : No it's expected at this age.
DrBrain : She needs to keep her cholesterol and sugar levels normal and also blood pressure.
Customer:

Thank you. Are you well qualified with the brain? Your impression of her


condition isn't as severe as we had feared. you think the MRI is basically

DrBrain : Vitamin B12 deficiency can cause this so once her levels are normal her memory would be better but at this age improvement would be very slow.
DrBrain : Youre welcome. I deal with atleast more than 10 patients a day with dementia so I am well aware of this type of condition.
DrBrain : I see more than 10 patients a day with this condition.
DrBrain : No it's not serious.
DrBrain : Mri is normal and age appropriate.
Customer:

Normal for her age? You think she could have or will have dementia, but not Alzheimer's?


Would another mri in a year or so determine alzheimer's?

DrBrain : MRI would not determine Alzheimer's. Dementia can become worse and can result in Alzheimer's.
Customer:

Thanks.


 

DrBrain, Neurologist
Category: Neurology
Satisfied Customers: 3262
Experience: Diplomate, American Board of Psychiatry & Neurology
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