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Dr Subbanna MD
Dr Subbanna MD, Neurologist (MD)
Category: Neurology
Satisfied Customers: 5373
Experience:  American Board Certified Neurologist, Internal Medicine
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I have mri results showing non-specific scattered foci

Customer Question

I have mri results showing non-specific scattered foci T2/FLAIR, hyperintensities. I suffer chronic refractory migraines. I have difficulty at times with recall of detail and some motor function at times with my hands. !st neuro called them lesions. are these injuries in the deep white matter of my brain
JA: Do you keep personal medical records to help track this?
Customer: Yes and frequent emergency room visits.
JA: Anything else in your medical history you think the doctor should know?
Customer: dx of fibromyalgia as well
Submitted: 11 months ago.
Category: Neurology
Expert:  Dr Subbanna MD replied 11 months ago.

Hi, I am an American Board Certified Neurologist with experience in diagnosing & treating all types of neurological & medical conditions including the concerns of brain MRI result you have mentioned here, and I am very glad to help you with your health concerns.

First I will ask few questions so that I can gather additional information related to your health concerns;

1) How old are you?

2) Have you ever lost vision in an eye, or did you suffer from episodes of muscle paralysis on one side of the body, or facial droop etc?

3) Have you had a spinal tap (lumbar puncture)?

4) Do you have any high blood pressure, diabetes, high cholesterol, triglycerides, or any history of smoking?

Customer: replied 11 months ago.
52. no, but visual disturbance. no. high b/p, triglycerides. smoker
Expert:  Dr Subbanna MD replied 11 months ago.

Okay I see. You meant smoker, or non smoker?

Expert:  Dr Subbanna MD replied 11 months ago.

Just double checking, you meant you have high bp, triglycerides, and you are a smoker, am I right?

Expert:  Dr Subbanna MD replied 11 months ago.

Hi, have you received my question posted above? I hope you are not encountering any technical glitches to access this site properly. If you require more time it is perfectly fine. Please take your time and reply when your time permits. I just wanted to double check with you on some information received from you earlier so that I give you correct answer to your health concerns.

Expert:  Dr Subbanna MD replied 11 months ago.

Hi, I had asked a question to double check some information received earlier from you, I have not received any reply from you, it looks like you do have history of high blood pressure and high triglycerides and also it seems you are a smoker, and I will give you my answer assuming that you have high blood pressure, triglycerides and also you are a smoker, if this is incorrect then please let me know.

Coming to the discussion;

You have asked a question whether the MRI spots seen in your report imply any brain injury in the deep white matter of the brain

The answer is both yes & no, this is because these spots could mean brain injuries, but even some normal people too show these type of brain spots. In some these spots may cause symptoms, and in some these spots do not cause any symptoms.

These types of brain spots can be seen in patients with chronic migraine

Patients with high blood pressure, triglycerides too can develop these spots – it appears that you have mentioned you are having these medical conditions, so these spots could be related to these. These medical conditions should be strictly controlled to prevent further development of these spots in the brain. Similarly smoking too can cause these spots, so quitting smoking too is recommended

As pointed above many times even normal people too have these type of brain spots

Rarely these spots can be due to conditions like MS (Multiple Sclerosis), or Cerebral vasculitis, chronic infections or inflammation of the brain, vitamin deficiencies, thyroid diseases, lyme disease etc too can cause these type of spots in the brain

If a spinal tap (lumbar puncture) has not already been done then please ask your neurologist to arrange for one, and the CSF (Cerebro spinal fluid) collected during spinal tap can help further, it can tell whether you have conditions like MS, or any other central nervous system chronic infections, or inflammatory conditions etc

If not already done then you also need an Angiogram study of the brain. Angiogram test is the study of the arteries supplying the brain (it will help to rule out conditions like brain vasculitis), and this test also checks for the blood flow within the brain. If this test is not already done please ask your neurologist for this test too

I am not sure whether you had blood tests to check for the thyroid, vitamin b12, folate, vit D level etc, if not already done then you need blood tests to check for these too, any of the above vitamin deficiencies, or thyroid disease etc can cause your symptoms

If blood test was not done to check for conditions like autoimmune connective tissue disorders then you also need blood tests to look for these possibilities, and blood tests like ESR, CRP, ANA, RA factor etc can help in this regard

If you were exposed to tick bites & lyme disease then you also need blood tests to check this possibility too, if not exposed then this test is not must

As discussed above there are various possibilities to explain the brain MRI findings and the symptoms you have mentioned, you may please ask your neurologist to arrange for the various investigations discussed above and then treated appropriately depending upon the test results.

Please let me know if you have any further questions, and please click a positive rating to credit for the time & effort put by me in answering your question.

Best regards,