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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Does Non-specific Demyelination In The Following MRI Report Suggest?

Hello, my neurologist scheduled an MRI in July 2017 for a slight intermittent tremor in my left hand and anxiety. The tremor did cleared up on it s own before my MRI. The neurologist told me the MRI was normal. I went on anti anxiety meds for 3 months and it is now manageable. Recently, (1/2/2018) I have an episode of significant hearing loss, severe tinnitus in left ear, dizziness, head pain on left side. The ENT has scheduled a 2nd MRI with contrast. They wanted the results of my first MRI which I just obtained but I do not understand the FINDINGS. Could you help decipher it for me: MRI HEAD BRAIN WITHOUT CONTRAST CLINICAL INDICATION: Weakness. Left hand tremors. Visual and hearing disturbances. Memory disorder. COMPARISON: None TECHNIQUE: There are T1-weighted 3-D TFE sagittal images with multiplanar reformations. There are FLAIR, T2-weighted fat suppression, diffusion-weighted axial, and FLAIR coronal images of the brain obtained on a 3 Tesla MRI unit. FINDINGS: Diffusion-weighted imaging is normal, without evidence of recent or acute ischemic event. There are nonspecific scattered white matter changes in the juxtacortical bilateral frontal white matter and juxtacortical and intermediate deep bilateral parietal white matter. This pattern can be seen with ischemic white matter changes that can be seen with migraine disorder as well as small vessel vasculopathy, but arguing against the latter possibility, there is no reported history of hypertension, the commonest cause of small vessel changes. Less common causes include prior history of vasculitis, Lyme disease, antiphospholipid antibody syndrome, etc. There is no deep periventricular demyelination to suggest multiple sclerosis. The ventricles are normal in size and shape. There are typical flow-voids in the major intracranial vessels. Noncontrast appearance of the cavernous sinuses, CP angles, and IACs is within normal limits. There is no middle ear or mastoid fluid. There are trace amounts of ethmoid and maxillary sinus mucosal thickening without active or acute sinusitis. IMPRESSION: NONSPECIFIC DEMYELINATION AS DESCRIBED. NO INDICATION OF SIGNIFICANT ATROPHY OR OF INTRACRANIAL MASS LESION OR LOCALIZED ENCEPHALOMALACIA The reports incorrectly stated my health history. I had hypertension for over 30 years which went completely away after bariatric weight loss surgery in 2013 (Vertical Sleeve not RnY). I went completely off blood pressure meds in 2013 after I lost 110 pounds. My weight is still off today. Any explanation of their findings will help my discussions with my ENT. Thank you! Dale Hogan
Wed, 14 Nov 2018
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Radiologist 's  Response
Hi,

It may be age-related demyelination.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Indu Kumar,
Radiologist
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What Does Non-specific Demyelination In The Following MRI Report Suggest?

Hi, It may be age-related demyelination. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Indu Kumar, Radiologist