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Friday, April 18, 2014
Periventricular white matter in my brain
Female-59 yrs.Please help me define the MRI of my brain. Diffusion weighted sequences were obtained through the brain. There is no evidence of midline shift, intra- or extra-axial fluid collection. IMPRESSION: Very minimal increased signal intensity is seen in the periventricular white matter on Flair images, most likely reflecting microvascular ischemic change. No parenchymal mass is seen. What does that mean?? Also, cervical spine MRI IMPRESSION: Mild to moderate, mutilevel, degenerative change with disk height loss, desiccation, and uncovertebral spurring. Bony neural foraminal compromise bilaterally at C5-C6 and significant uncovertebral spurring as with C6-C7. At C7-T-1 broad-based and central disk bulging,eccentric to the left without significant central canal, neural foraminal, or lateral recess narrowing. Both MRI were done at the same time; could you please tell me if I`ve possibly had a small stroke? Could my degenative discs cause whatever is happening in my brain??? My head feels numb and face tingles, around the lips and cheek. All symtoms are on the left side of my face; skull; tingling left shoulder to finger tips; left leg weakness. Thank you
For information about periventricular white matter changes, see the answer to "Help interpreting MRI results" dated 9/14/05. These sort of MRI changes are most commonly seen with aging, especially in the presence of risk factors such as high blood pressure and diabetes. Small strokes in the "subcortical" (below the surface of the brain) region can appear similar to the periventricular white matter changes of aging, but these are associated with the sudden onset of clinical symptoms. If your symptoms came on suddenly, then it is possible that you have had a small stroke. I cannot provide a diagnosis based on your MRI report--it is best that you continue to work with your doctors.
As to the changes in your spinal cord, these again are typically seen in people as they age. These imaging findings are the "wear and tear" on your spine over time and the report suggests that there is no compression of your spinal cord or any of the nerve roots. It is not likely that these findings are related to your symptoms.
Again, please continue to work with your doctors. My comments above are very general. It is crucial to put imaging findings in context of a full medical history and physical exam, which I cannot do.
I hope this answers your question.
Brett Kissela, MD
Assistant Professor of Neurology
Director, Neurology Residency Program
College of Medicine
University of Cincinnati