Brief Answer:
Large ventricles can be caused by a number of things

Detailed Answer:
There are a number of disorders that can caused "large lateral ventricles and subarachnoid space" widening. However, one must be careful that these are taken in context with the clinical setting. You are 50 years old. It would be unusual for you at such a young age to have these enlarged ventricles since that process shouldn't really start until at least 15-20 years from now. Another thing to remember is that the radiographic description of the size of your ventricles, the width of your subarachnoid spaces, and "decrease in volume of brain parenchyma" (i.e. brain shrinkage) are not based upon any comparison films. The radiologist is essentially making a call in the dark because to their eye your picture LOOKS bigger than what he/she's used to seeing.

Things that can cause this picture, however, would be:

1. Dementing process (takes YEARS for these findings to develop)
2. Aftermath following meningitic infection, brain abscess, or other severe viral type of infection such as Herpes, EBV, etc. (takes YEARS for this to develop)
3. Obstructive HYDROCEPHALUS (you would likely get enlarged ventricles but if anything your subarachnoid spaces would get narrower not wider). Also, you would likely have a terrific headache, with nausea, vomiting, and you'd be falling down, and maybe even having a hard time staying awake and alert....doesn't sound like you.....
4. And the most common reason that someone has enlarged ventricles with what appears to be decreased parenchymal volume and widened subarachnoid spaces....is because that's the way they were born (assuming they have no other neurological deficits or any of the things I mentioned up top).

I'm not aware that people with OCD diagnoses suffer from the radiographic findings you present with any regularity or consistency and therefore, that counts as a red herring in my opinion.

If you'd like to upload your MRI images to a dropbox account or upload a few images on this site I would be happy to look at them but my opinion is that radiographic findings are not helpful to your diagnosis of OCD....or anything that's going on at this point since you sound to be neurologically otherwise intact.

If I've satisfactorily addressed your question then, could you do me the kindest of favors by CLOSING THIS QUERY and be sure to include some fine words of feedback and a 5 STAR rating to our transaction if you feel the response has helped you? Again, many thanks for posing your question.

Do not forget to recontact me in the future at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic or others. I would be interested in knowing how things turn out when you've seen the neurologist. And do look for someone who can get you in soon....as in within the next week or so at the latest. His behaviors seem out of control and escalating and could be dangerous to himself and even others.

This query has utilized a total of 15 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.

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Brief Answer:
Mil Disculpas

Detailed Answer:
Thank you for your clarifications and I stand corrected. You never did say you were diagnosed with Obsessive Compulsive Disorder (OCD). Please keep in mind as well that my ability to comment precisely on the psychiatric side of your question is limited because I am a neurologist not a psychiatrist.

Therefore, in answer more directly to the question of whether or not you have some kind of "neurological problem" based upon the presented symptoms and MRI/MRA results I would say that a thorough history and physical examination would need to be completed by a neurologist before making any definite conclusion that you either do or do not have a problem.

However, assuming for the moment that there is nothing focal going on and your history is only significant for what you state as having a "compulsion" for looking at open car windows and the MR results I can't conclude that there is any neurological deficit present.

Abnormal reactions to psychiatric medications does not necessarily equate either to having psychiatric (or neurological) problems. You could be suffering from side effects, drug to drug interactions, or displaying what are referred to paradoxical reactions but in none of those cases can we conclude a disease process based on the given information.

As far as other MRI/MRA's being done in the past the only way to truly know that the current findings don't exist is to pull those films and have them re-read (either by another neuroradiologist or the one who read this particular study) so that the report calls of reduced brain volume, enlarged ventricles, and widened subarachnoid spaces can be investigated. Remember, not all radiologists will have the same threshold for calling these parameters. Sometimes, calls are frankly missed. Other times, they're not made because the doctor believes that any slight variance falls within their construct of normal structure. Others may not feel that the findings are not relevant to the clinical picture (this would be the worst reason for someone NOT to make a call that is obvious on a scan)-- but it happens.

In other words, absence of a call does not equal absence of findings.

Bottom line is the comparison of the films will answer your particular question as to whether or not the radiographic findings in the latest report pre-existed or not.

In conclusion, I do not find there to be strong evidence in favor of any type of neurological problem based upon your symptom of looking preferably upon open windows of motor vehicles nor upon the evidence in the MRI/MRA studies which found some degree of reduced brain parenchyma, increased ventricular size, and widened subarachnoid spaces. Your reaction (whether abnormal or not) also is not of importance in determining the presence or absence of either a neurological or psychiatric condition. Also, the only way to know whether current imaging findings pre-existed or not would be to pull previous studies and make a direct comparison to the one at hand.

If I've satisfactorily addressed your question then, could you do me the kindest of favors by CLOSING THIS QUERY and add some positive feedback and a 5 STAR rating to our transaction if you feel the response has helped you?

Again, many thanks for posing your question and don't forget to recontact me in the future at: www.bit.ly/yyyyyyyyyyyyyy for additional questions, comments, or concerns having to do with this topic or others.

This query has utilized a total of 52 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.

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