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I just got an MRI diagnosis of encephalomalacia and gliosis.

I just got an...

I just got an MRI diagnosis of encephalomalacia and gliosis. I am 80 years old and am having double vision and headache. Is all this related? I have not been referred to a neurologist yet.

Doctor's Assistant: Is the headache episodic or daily? And what about nausea?

It is pretty much episodic, but happens periodically every day. I have had no nausea.

Doctor's Assistant: Anything else in your medical history you think the doctor should know?

The radiology report says no evidence of acute infarction and I have had no head injury.

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Answered in 2 minutes by:
3/7/2018
Dr. Muneeb Ali
Dr. Muneeb Ali, Intensivist
Category: Neurology
Satisfied Customers: 9,185
Experience: Experience of Neurology of over 4 years, well versed in EEG, NCS and EMG alongwith MRIs and CT scans
Verified

Hi,

Welcome to JA and thanks for this question. Im sorry to hear about your symptoms. Can i ask did you ever have a stroke in the past? Also can you upload the whole MRI report here or a picture of it?

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Customer reply replied 1 month ago
I have never had a stroke - I will try to upload the MRI report.

Thanks for the additional information, let me just write down an answer for you and ill get back to you in a few mins. If you get a phone call request, that is an automated site response. I DID NOT send it. Thanks!

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Actually, your MRI shows softening of the brain (encephalomalacia) and growth of certain cells in the brain referred to as glial cells (gliosis). These two changes classically occur after a stroke which has damaged the brain or after traumatic brain injury. Since you did not suffer any sort of injury, a stroke is still a possibility, the reason being that the remainder of your report does show chronic ischemic small vessel changes. These changes indicate that the very small vessels in the brain have been occluded, either due to inflammation or due to clots blocking the vessels. You could have had a stroke and NOT suffer from the classic symptoms of weakness and numbness in the body because of the location. It can cause simple cognitive deficits or memory issues. The location of the stroke is right at the front of your brain so it is possible that it missed involving those areas which control the movement of the limbs and the sensory systems.

There are other possibilities for this to occur, which could include infections in the brain or old inflammation in the brain which led to this problem.

Regardless of the cause, these changes, unfortunately, cannot be reversed. But coming to your question YES these can cause the headaches and the double vision that you have. The headaches and the double vision can be controlled with medications but they cant be cured, unfortunately.

Do you have any more questions?

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Dr. Muneeb Ali
Dr. Muneeb Ali, Intensivist
Category: Neurology
Satisfied Customers: 9,185
Experience: Experience of Neurology of over 4 years, well versed in EEG, NCS and EMG alongwith MRIs and CT scans
Verified
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Customer reply replied 1 month ago
Because the headaches and double vision just became apparent recently do you think the event in my brain happened just recently as well?

No not recently, because encephalomalacia and gliosis usually occur after some time, months usually. These are not recent changes they have been present for some time. Also at the same time while these symptoms can be due to the changes in the MRI, i would nevertheless exclude all other cause for them as well such as migraines, other headache disorders. The reason being that while it is very easy to attribute your symptoms to these changes, it may cause us to overlook another treatable cause which is why i think other disorders should be ruled out as well.

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Customer reply replied 1 month ago
During the night last night I had the most excruciating headache I have ever had in my life. It lasted approximately an hour. It has lessened considerably but I still have a headache this morning. I have still not heard from the local neurologist either. Does this need immediate attention?
If you have a severe headache or the worst headache of your life then yes you need immediate attention.
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Dr. Muneeb Ali
Dr. Muneeb Ali
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Category: Neurology
Satisfied Customers: 9,185
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