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Had A Brain MRI. Have Had Chronic Pain, Chronic Headaches,

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Posted on Thu, 23 Jun 2022
Question: Had a brain MRI. Have had chronic pain, chronic headaches, hyperreflexia, and some twitching. Currently diagnosed with Ankylosing Spondylitis and Ehlers Danlos Type 3. What does the below result mean?

Midline developmental anatomy is well formed. The ventricular system is
appropriate in caliber and configuration. No intraaxial masses or focal mass
effect. Cerebrospinal fluid spaces are well maintained. The basal cisterns are
patent. There is no restricted diffusion to indicate acute infarction. No
abnormal hemosiderin deposition is evident within the brain on gradient echo
imaging.

There are a few (at least 6) punctate foci of increased FLAIR signal in the
bilateral frontal subcortical white matter. These are highly nonspecific but
often seen as sequela of remote brain insults such as prior trauma, ischemia, or
infection. Migrainous vasculopathy and CNS vasculitis are in the differential.
Although demyelinating disease is technically consideration the pattern is not
particularly suggestive. Post-contrast imaging shows no abnormal intracranial
enhancement. There are small mucus retention cysts in the maxillary sinuses
bilaterally. There are no significant mastoid effusions.

IMPRESSION:

No acute or significant structural intracranial abnormality. A few punctate
bifrontal white matter hyperintensities are noted, highly nonspecific but often
representing sequela of remote brain insults such as prior trauma or ischemia.
These can also reflect migrainous vasculopathy.
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Follow up: Dr. Dr. Erion Spaho (6 minutes later)
As well I have been having dizziness and lower cognitive function.
doctor
Answered by Dr. Dr. Erion Spaho (15 hours later)
Brief Answer:
Changes mostly due to unstable blood pressure. Other conditions to consider

Detailed Answer:
Hello and welcome to the "Ask a Doctor" service.

I have read your question and the MRI report that you uploaded.

These MRI findings don't constitute a disease but may be encountered as a consequence of several conditions.

These small changes found deep in the brain are mostly linked to unstable blood pressure, ischemic events, history of migraines, etc.

Multiple sclerosis is rarely linked to these MRI features, but a spinal cord ( cervical and thoracic) MRI is necessary to understand correctly this possibility.

Since you were diagnosed with Ehlers- Danlos (a condition that affects the connective tissue ), small vessels disease is also possible.

In conclusion, these MRI changes don't justify your symptoms and may be an incidental finding, spinal cord MRI is necessary as well to exclude multiple sclerosis.

Discuss with your Neurologist for these issues.

Hope you found the answer helpful.

Let me know if I can assist you further.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Erion Spaho (10 hours later)
Today I was diagnosted with POTS/Orthostatic Intolerance. Would this explain it?
doctor
Answered by Dr. Dr. Erion Spaho (41 hours later)
Brief Answer:
I would explain as follows.

Detailed Answer:
Hello again.

POTS is actually linked to unstable blood pressure, so, it may be an explanation for these MRI findings.

Hope this helps.

Take care.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Dr. Erion Spaho

Neurologist, Surgical

Practicing since :2004

Answered : 4495 Questions

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Had A Brain MRI. Have Had Chronic Pain, Chronic Headaches,

As well I have been having dizziness and lower cognitive function.