The above includes what was the first line written under "impressions" on my radiology report related to an MRI done w/o and with Contrast which I was given recently. I'm going to see my neurologist today, but can tell you what I know now. The doctors I've spoken with so far expressed concern, then some calming words such as, "the report wasn't conclusive," as the radiologist had included a number of possible reasons for the results. However, I've since read the fact I had an MRI six years ago during which this foci was not present, this presents a problem. The fact the foci is in the periventricular area typically suggests a diagnosis of Multiple Sclerosis. However, my neurologist ask to look at the films himself, to confirm this foci or lesion, is new. If it is indeed a new lesion, this signifies a diagnosis of either Multiple Sclerosis or another demyelinating disease. (Note: I had a "small foci" of "abnormal T2 Flair" rather than being scattered. )
It could be related to prior infection, trauma, inflammation, or
demyelinating disease.
Can hyponatremia cause white matter suggestive of minimal chronic microvascular ischemic change. The grey-white differentiation is maintained. minimal chronic microvascular ischemic on a brain scan?
ms
Cortical is a word referring to the cortex, so the subcortical region of the brain is literally 'anything beneath the cortex'; but, since the brain isn't arranged in flat layers, it may be easier to visualise this analogy: If you picture the brain as being half an orange, the outer skin (the zest) would equate to the grey matter of cerebral cortex, & the inner skin (the pith) to the white matter; everything else (the pulp & the pips of the orange) represents the subcortical structures, which include various ventricles & nuclei, the thalamus, hypothalamus, cerebellum, & the parts that make up the brainstem. Subcortical pathways enable fast, unconscious reactions; so a reflex is a subcortical action.
Periventricular White Matter Disease is not actually a disease. This misnomer comes from health practitioners referring to it as such, but periventricular white matter is commonly occurring on the brain, and changes in this matter are common as people age. Lesions, which are identified through imaging, may lead to a "disconnect" between certain regions of the brain, thereby creating confusion, poor balance or dementia.CausesPeriventricular White Matter (PWM) has several causes, including aging, mini strokes or conditions related to multiple sclerosis. Studies have shown that more than a third of MRIs done on people over age 65 show some PWM. The condition has also been linked to a vitamin B6 deficiency. PWM might be caused by small strokes or migraines. Researchers believe that small bleeds in the brain are sometimes the cause of the lesions.SymptomsAmong the symptoms of PWM is reduced walking speed and difficulty with balance. And while walking more slowly is a symptom, it is not necessarily indicative of a lesion as people tend to walk more slowly and carefully as they age.Another symptom may be confusion or reduced mental ability. Depending on the location of lesion, the capability to think clearly or perform a certain task may be impaired.PreventionTaking small doses of B6 supplements and reducing stress are recommended. Reducing hypertension and quitting smoking are also key preventative measures. In addition, 20 percent of those suffering from migraines have a 20 percent chance of developing lesions (compared to 1.4 percent of the general population). Managing migraines using beta blockers in combination with other migraine medication is key to lowering the risk of developing lesions.TreatmentOnce lesions have appeared, the effects are permanent. Treatment may help to adapt to new issues (i.e. unsteadiness) or slow the process, but as yet it cannot be reversed. Physical therapy is a key component of managing PWM. There is little evidence to show that a drug regimen will help to diminish the effects of PWM. However, research suggests that antidepressants and antiparkinsonian medications may be helpful in some cases. In addition, if a patient is already taking medication that impacts the brain or ability to think, tweaking the dosage or switching to a similar medication may help alleviate the symptoms.ConclusionPWM may be preventable, but should you develop it, the key to living with it is finding a way to manage it. While there is no indication that if one lesion appears, others will follow, individual lesions may get larger over time, causing additional impairment. Location of a lesion is also important with regards to what motor skills are affected. Physical therapy will help to manage the affected skills.Source in related links.
grey matter
what does this mean? Impression: There are scattered foci of T2/FLAIR hyperintensity within the periventricular, deep and subcortical white matter. The findings are nonspecific but may be seen in mild to moderate small vessel ischemic changes. No evidence for acute infarct or hemorrhage.
Mild diffuse cerebral and cerebellum volume loss and T2 hyperintensity within the periventricular white matter refers to a stroke. This can cause a slight decrease in the white matter of the brain.
Small hypo densities are seen in bilatereral para ventricular region
This phrase is a statement that would be used by a radiologist when reviewing the results from a MRI. Breaking down the phrase by individual parts:T2 - An indication of the type of scan that was done. In a T2-weighted scan, areas that are fluid-filled appear bright, while areas that are fatty appear dark. A T1 scan would show the opposite results.Hyperintensity - An indication of a bright region on the scan.Foci of T2 Hyperintensity, therefore, means "focal points, or concise areas, of very bright spots."Subcortical and periventricular white matter - These are locations within the brain. Regions of the brain are categorized by color (white matter or grey matter) and location (cortical, or related to the cortex, subcortical, or below the cortex, etc).The statement, therefore, means "white spots on a MRI scan at certain locations within the brain."This statement alone does not indicate any particular disease is present. It is a piece of information that a neurologist would use to help determine whether or not someone had a certain disease or condition. There are many conditions or diseases which can cause white spots on the brain; only a neurologist can sort through the possibilities and determine what caused these white spots.
Can hyponatremia cause white matter suggestive of minimal chronic microvascular ischemic change. The grey-white differentiation is maintained. minimal chronic microvascular ischemic on a brain scan?
Dx Code - 348.8
What does this mean in easy to understand terms
The white matter is the area of the brain where signals travel to other parts of the brain. It is located in the subcortical area.
ms
Subcortical white matter lesions may be associated with cardiovascular disease. They may also be associated with multiple sclerosis, if the patient has other MS signs and symptoms.
'Subcortical structures' are areas of the brain below the cortex, which is the outermost layer (i.e., the grey matter). The limbic system is one example of a subcortical structure - although technically it isn't just one structure. The limbic system actually consists of a number of key areas related to sensory integration, learning, memory, emotionality, and decision-making. See: http://en.wikipedia.org/wiki/Limbic_system
Cortical is a word referring to the cortex, so the subcortical region of the brain is literally 'anything beneath the cortex'; but, since the brain isn't arranged in flat layers, it may be easier to visualise this analogy: If you picture the brain as being half an orange, the outer skin (the zest) would equate to the grey matter of cerebral cortex, & the inner skin (the pith) to the white matter; everything else (the pulp & the pips of the orange) represents the subcortical structures, which include various ventricles & nuclei, the thalamus, hypothalamus, cerebellum, & the parts that make up the brainstem. Subcortical pathways enable fast, unconscious reactions; so a reflex is a subcortical action.