Brief Answer:
Interpretation of MRI in details given below

Detailed Answer:
Hi XXXXXXX,
Thanks for writing in to us.

I have read through your query in detail.
The positive findings in your MRI scan are

1. There is a chronic lacunar infarction within the left corona radiata, with a few additional punctate foci of T2 hyperintensity also identified within the right parietal white matter.

This indicates probably an old area of lacunar infarction which has been reported since 2003. There is also mention of a few small pin head size of possible ischemic changes in the right parietal lobe.

2. There is a right parietal developmental venous anomaly with no pathologic intracranial enhancement identified.

This suggests that few abnormal draining veins have been noted in the right parietal region but they are not causing any problems in the area.

The final result of the MRI scan there is no sign of any brain injury in the recent past. The ischemic changes due to decreased blood supply seen on left side are pre existing with the new areas in right parietal lobe might be due to recent (weeks to months) deficient blood supply.

The described findings are not related to your headache after injury. Should you be having any risk factors for stroke, they need attention and treatment. The developmental venous anomaly is a variation from the normal and not a concern.

Hope your query is answered.
Do write back if you have any doubts.

Regards,
Dr.Vivek

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Brief Answer:
Your work up is as per guidelines

Detailed Answer:
Hi
Thanks for writing in with an update.

There is a certain pattern of immune related proteins called oligoclonal bands which are seen in patients of MS. Studies show that over 90% of people with MS have oligoclonal bands in their CSF. While increased immunoglobulin in the CSF and oligoclonal bands are seen in many other brain and spinal cord conditions, their presence is often useful in helping to establish a diagnosis of MS. However MS can rarely occur even without this finding.

An echo is definitely necessary to evaluate the general functioning of the heart and the presence of any clots in particular. In some patients a carotid artery Doppler may also be done to know the blood flow pattern from heart to brain.
XXXXXXX strokes syndrome (TIA) is a condition in which usually due decreased blood supply in small areas of brain leading to brain related symptoms such as weakness, confusion, speech difficulties, lack of coordination and may vary with patients. These are repetitive in nature and are linked to abnormal blood supply to the brain.

When a MRI brain shows features described earlier and you have been having neurological problems since months to years, it is important to rule out certain specific conditions which includes MS and TIA. You must discuss your symptoms in detail and this can help in making the right diagnosis. Scans are also repeated to evaluate MS.

Hope your query is answered.
Do write back if you have any doubts.

Regards,
Dr.Vivek

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