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Dr. David
Dr. David, Board Certified MD
Category: Neurology
Satisfied Customers: 44862
Experience:  Experienced physician in Neurology
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MRI brain without contrast: Seen best on flair images, there

Customer Question

MRI brain without contrast:
JA: Have you seen a doctor about this yet? What medications are you taking?
Customer: Seen best on flair images, there is a slight nodularity along the margin of the right lateral ventricle, the significance of which is uncertain. Contrast emhanced MRI is recommended for furthur evaluation.
JA: Anything else in your medical history you think the doctor should know?
Customer: Some memory issues
Submitted: 5 months ago.
Category: Neurology
Expert:  Dr. David replied 5 months ago.

Hello, this is Dr. David. I am reviewing your question now and will be with you momentarily.

Expert:  Dr. David replied 5 months ago.

how old are you?

why was contrast not used on your first brain MRI scan?

Customer: replied 5 months ago.
52 years old male
It was ordered with contrast but insurace denied it.
Customer: replied 5 months ago.
Also Diffusion weighted images demonstrate no evidence of acute ischemia. Flair images demonstrate few scattered white matter hyperintensities in both cerebral hemishpheres, consistent with nonspecific foci of gliosis. These could be on the basis of mild chronic small vessel ischemic change especially if paitent has history of accelerated hypertension or diabetes.FYI no history of diabetes or high blood pressure.
Expert:  Dr. David replied 5 months ago.

I have to look at your MRI scan.

or you can upload a copy of your MRI scan report.

these slight modularities may not be anything. they could be curvy blood vessels at the margin of the lateral ventricle.

Customer: replied 5 months ago.
Here is a copy of the Report. This is my husband and he has been experiencing some memory loss and cognitive issues. I am concered he has early onset Alzheimers. Blood work has come back normal. His Physician is out of town. He also has some slight personality changes and seems unattached to converstions at times.
Expert:  Dr. David replied 5 months ago.

early onset alzheimers disease is a clinical diagnosis and would not be made by findings on a brain MRI scan.

it sounds like his MRI scan is recommending contrast be performed for his brain MRI scan.

the MRI scan shows evidence of small vessel disease which can cause poor blood flow to the brain,

smoking, diabetes, poor diet, lack of exercise, high cholesterol, obesity can all cause small vessel disease in the brain.

Customer: replied 5 months ago.
He hase no history of smoking, diabetes, poor diet, lack of exercise, high choleserol, or obesity. Could it be a small benign tumor of the lateral ventricle?
Expert:  Dr. David replied 5 months ago.

I doubt he has a small benign tumor in the lateral ventricles.

I am a cancer doctor.

Customer: replied 5 months ago.
there is nothing on the MRI to be concerned about?
Expert:  Dr. David replied 5 months ago.

he needs a repeated brain MRI scan with contrast.

a closed MRI scan images are better than open MRI images and more clear.

the MRI scan suggest there could be some gliosis due to small blood vessel disease.

he should see a neurologist if he is having memory problems and behavioral changes.

he may need more testing to see why his blood vessels may be inflamed if he has no history of diabetes or high blood pressure or high cholesterol

let me know if you have other questions.

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Customer: replied 5 months ago.
Thank You
Expert:  Dr. David replied 5 months ago.

you are welcome

do you see the ratings area?