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Dr. Frank
Dr. Frank, Board Certified Physician
Category: Neurology
Satisfied Customers: 9000
Experience:  Board certified general Adult Neurologist, with experience in experimental neuroimaging and neurodiagnostics.
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Need help reading an MRI

Customer Question

need help reading an MRI
Submitted: 1 year ago.
Category: Neurology
Expert:  DrRussMd replied 1 year ago.


Type in the report here

Customer: replied 1 year ago.
same day...CT.. FINDINGS..There is cortical and central atrophy, periventricular white matter changes suggest chronic small vessel ischemia.
MRI A few punctate bright T2 foci are seen in the periventricular white matter in the parietal-occipital regions.bilaterally. likly a manifestion of small vessel ischemic disease..flow voids normal.. there is cavum septum pellicidum and cavum verage small vessel changes of white matter...
Expert:  DrRussMd replied 1 year ago.


So what this is saying is that there are small blood vessels in the brain that have broken, and that the brain has shrunk to a degree.

This is consistent if one is aged.

It can be from hypertension.

It can be seen in multiple sclerosis.

However, they did not see actual multiple sclerosis type lesions.

It can be seen after inflammation of the brain from autoimmune disease.

It can be without known cause as well.

You need an exam from a neurologist, and this will correlate with the scan and give it meaning.

OK, so you might have more questions or want to give me more information: Please use reply to expert if you have further questions. When you are ready, please click a positive rating [hopefully excellent—that’s how we are paid, per rating]. If you forgot something, come back. I am here daily.

Customer: replied 1 year ago.
sorry also.. cortical and central atrophy...and I am a pro fighter..2 concussions that i know off..and fractured orbital 3 x the last time needing surgery..with an implant..
Expert:  DrRussMd replied 1 year ago.

Yes the atrophy means some shrinkage in the middle/top of the brain.

Multiple concussions might do this as well.

Still need to see a neurologist.

please click a positive rating [hopefully excellent—that’s how we are paid, per rating]. If you forgot something, come back. I am here daily.

Customer: replied 1 year ago.
ok but thats not really the answer I want.what is the future? keep in mind i have been hit in my head since age 5..what can i do..etc thank u!
Expert:  Dr. Frank replied 1 year ago.

Hello Welcome to JA. I am an Adult Neurologist specializing in Neuroimaging and can answer your question. You have changes in your periventricular white matter termed leukoaraiosis, which can be a problem of the microvasculature. It is a non-specific finding as termed by Fazekas in 1987. It can be seen in migraine, smoking, family history of this type of change, diabetes, hypertension, high cholesterol, it can be seen in trauma as well, so your concussions could be contributory. The other finding of cavum septum pellucidum and cavum vergae are normal variants of neuroanatomy and by themselves do not suggest an acquired problem. It is just the way your brain was formed from gestation.

What I do not see is mention of cortical atrophy on the MRI, which is a much better way to measure that type of change. Do you have anything else on the MRI report? If not, it could be that the CT findings of cortical and central atrophy are incorrect and not substantiated on the MRI. Get back to me to discuss this further and I will reply, or if satisfied, please remember to rate my service by clicking on the rating stars, as that is how I am compensated for this work thanks *****

Customer: replied 1 year ago.
is there a way to send you the report? like in an email or anything?
Expert:  Dr. Frank replied 1 year ago.
Hi. There is an upload button on the page you are looking at. If you upload it please leave your name off the report as this is a public forum. You can take a picture of the report and upload that ok ? Dr Frank