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Dr. Frank
Dr. Frank, Board Certified Physician
Category: Neurology
Satisfied Customers: 7201
Experience:  Board certified general Adult Neurologist, with experience in experimental neuroimaging and neurodiagnostics.
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this is greek, and my docs are out till this week...what does

Resolved Question:

this is greek, and my docs are out till this week...what does this mean? I had eye pain had to go to er, they gave me decdron and iv soluprednisone and two weeks of prednisone. that was a few weeks ago and now had mri. could someone explain this to me? thank you!
As viewed on sagittal t1 sequence the midline intracranial structures are normal. There are no diffusion weighted signal abnormalities to suggest an ischemic event. No intracranial mass lesion. No extra-axial fluid collections. Brain volume is age appropriate. Mild nonspecific white matter disease with small foci of t2 and flair signal hyperintensity in the subcortical, deep white and periventricular regions of the supratentorial brain. In total there are approx 10 signal abnormalities. No signal normality within the cerebellum or brainstem. Note made of a developmental venous anomaly in the right cerebellar hemisphere. There are no area of pathologic intracranial enhancement. None of the the T2/flair signal abnormality shows corresponding enhancement or diffusion signal abnormality. No gradiant signal abnormality. The major intracranial vascular appears patent. The mastoid air cells and imaged paranasal sinuses are clear.

Orbit mri
The optic nerves are normal, no optic nerve swelling, t2 signal abnormality or enhancement. The optic chiiasm and optic tracts are normal. The extraocular muscles are normal, globes are normal. No mass lesion
Impression
Mild nonspecific white matter changes, abnormal for patient age. Most likely considerations include a demyelinating condition such as multiple sclerosis, sequel from migraines, or chronic small vessel disease as it pertains to hypertension or diabetes.
Normal orbital MRI, no findings of optic neuritis
End of diagnostic report for accession.
Submitted: 12 months ago.
Category: Neurology
Expert:  Dr. Frank replied 12 months ago.

neuromd2012 :

Welcome to Just Answer. I am an Adult Neurologist and was contacted to answer your question.

neuromd2012 :

as you are offline. I will leave you an answer about your MRI. Please get back to me with questions

neuromd2012 :

So the most important thing about this current MRI is to compare it to the last MRI (there is no comparison, did you have it at a different location?)

neuromd2012 :

Your orbital (eye) MRI was normal

neuromd2012 :

your brain MRI was abnormal in the sense it shows non-specific findings, that are commonly seen in "normal" patients.

Customer:

i had a brain mri in may 2013 which was normal.

neuromd2012 :

hi

Customer:

thiss was the mri results from couple days ago : )

neuromd2012 :

right

Customer:

hi thank you for your help

neuromd2012 :

this MRI still needs to be compared to your old MRI

Customer:

it was

neuromd2012 :

ok

Customer:

same hosp

neuromd2012 :

so then the UBO's (unidentified bright objects) are new

Customer:

yes sir

neuromd2012 :

and that is important

neuromd2012 :

these changes are non specific, meaning they can be seen is a variety of conditions

neuromd2012 :

migraine headaches

neuromd2012 :

diabetes, hypertension, high cholesterol, smoking

neuromd2012 :

a family history of stroke or heart attack

Customer:

i also have history of migraine (aura only) not for quite some time though

neuromd2012 :

they can be seen in vasculitis, as related to rheumatoid arthritis

neuromd2012 :

but you last MRI was normal, without these changes correct?

Customer:

yes, normal no findings

neuromd2012 :

so you have to consider more acute changes

neuromd2012 :

like demyelinating disorders, since you have fibromyalgia, have they done

neuromd2012 :

a vasculitis screen, ?

neuromd2012 :

sedimentation rate, ANA, RA?

neuromd2012 :

considered MS?

Customer:

my blood tests all came back normal in may. they were ruling out ms because my may mri came back normal, so dxd me with fibro

neuromd2012 :

I see

Customer:

does this change that?

neuromd2012 :

did you get an LP (lumbar puncture?)

neuromd2012 :

it could

Customer:

no

neuromd2012 :

yes what happened with your eye?

neuromd2012 :

did you lose vision?

neuromd2012 :

could you have optic neuritis?

neuromd2012 :

you need a vision test called visual evoked potentials (VER's)

Customer:

woke up and eye hurt to move (right eye).... saw black spots then they went away. next day hurting badly went to eye doc and then er that noght - severe pain with nausea. saw optomologist started me on 4 days iv solosterois and prerdinsone

neuromd2012 :

well, they are treating you for optic neuritis it sounds like

neuromd2012 :

and your symptoms suggest it

Customer:

it healed my eye pain in a couple days.... just had spot like smear on sunglasses for a bit

neuromd2012 :

optic neuritis can be the first presentation in MS

Customer:

yes, but mri said no optis neurits finding

neuromd2012 :

correct

neuromd2012 :

that is why you need those VER's

neuromd2012 :

ok?

Customer:

VER?

neuromd2012 :

that vision loss in the middle could be called a centrocecal scotoma

neuromd2012 :

visual evoked potential

neuromd2012 :

it measure your optic track function

neuromd2012 :

more sensitive than the MRI

neuromd2012 :

and you may need that LP as well

Customer:

i had like 4 hours of testing there (neuro opthomologist, she said optic neuritis but i assue i didnt have that afterall since my MRI says no finding?

neuromd2012 :

if you want to see if there are changes in your cerebrospinal fluid consistent with MS

neuromd2012 :

well the MRI should show changes in the optic nerve or the optic track

neuromd2012 :

but it doesn't alway

Customer:

oh is that a blood test...than you fo being so helpful,

neuromd2012 :

no

neuromd2012 :

VERs are a test where you look at a checkerboard pattern

neuromd2012 :

in front of a TV

neuromd2012 :

with a lot of wires on your head

neuromd2012 :

did you do that already?

Customer:

oh i see, i did not do that one.... some type of periphreal light testing and machine that said i had astigmtisms

neuromd2012 :

yes, this is totally different

neuromd2012 :

you need to ask your neurologist, or see a neuro-ophthalmologist

neuromd2012 :

but that is the big issue on your MRI

neuromd2012 :

as I mentioned, this could all be "normal" but not if it wasn't there on your earlier scan

neuromd2012 :

I don't know why they didn't mention that these were new changes????

Customer:

well they did say mild nonspecific white matter changes, abnormal for patient age i guess. are those spots the same ones with ms also or different type?

neuromd2012 :

MS really can look much different

neuromd2012 :

in terms of the number and the distribution, and the size of each individual lesion

neuromd2012 :

so really this MRI is "normal" in a sense.

neuromd2012 :

if there is a consideration that this could be MS

neuromd2012 :

there are additional MRI imaging studies that can be done that are more specific

neuromd2012 :

one is called DTI

neuromd2012 :

diffusion tensor imaging

neuromd2012 :

and that looks at your white matter connections, to see if it is consistent with MS

neuromd2012 :

so as you can see

neuromd2012 :

this can get a bit complicated

neuromd2012 :

and nothing here is definite of anything

Customer:

i just wish i could be fixed, ive had horrid chronic pain since my spine surgery and now this numbness and vibrating in my left back...i wondr if its from those spots

Customer:

thanks for all your patience you were very helpful in answering my questions : )

neuromd2012 :

unfortunately, it could be from the spots

neuromd2012 :

if you have demyelinating disease

neuromd2012 :

I would encourage you to get a Lumbar puncture for confirmation about demyelinating disease if you are having symptoms, and based on this eye pain episode ok?

neuromd2012 :

as you can see, this is a very difficult diagnosis to make or exclude

neuromd2012 :

but you want to find out, as treatment early is the key to success

neuromd2012 :

that we have figured out

neuromd2012 :

ok?

Customer:

ok : ) i will look in to that, thank you so much. have a great evening and thanks for giving me a little piece of mind in this waiting game : )

neuromd2012 :

you are welcome

neuromd2012 :

please come back anytime if I can help

neuromd2012 :

Dr Frank t

neuromd2012 :

bye

Dr. Frank, Board Certified Physician
Category: Neurology
Satisfied Customers: 7201
Experience: Board certified general Adult Neurologist, with experience in experimental neuroimaging and neurodiagnostics.
Dr. Frank and other Neurology Specialists are ready to help you
Expert:  Dr. Frank replied 12 months ago.
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