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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Does The MRI Show?

Hi I am a 51 year old female with a month history of paresthesias of the left trunk area as well as down my left leg and toes. My FP ordered a MRI of brain. Results showed few punctate foci of abnormal T2 signal hyperintensity within the periventricular and subcortical white matter with largest 1.2 cm. Chronic small vessel ischemic changes versus exterminating type disease. Doctor said normal and just age related but concerned because of symptoms. Now has ordered MRI of thoracic and lumbar spine. What do u think about the MRI results???
Tue, 26 May 2015
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Neurologist,  's  Response
Well the area of problem you are describing -- the left trunk area and left leg -- would not really fit into a lesion in the brain so it's good he ordered and MRI of the spine. If the thoracic and lumbar are normal, you should still have an MRI of the cervical spine.

Regarding the current MRI results -- over the last 3-4 decades that MRI has been around, many patterns have been seen and studied. Chronic small vessel ischemic changes are like having "plaque" in the brain in parts that usually don't manifest clinically. There are lots of tiny blood vessels in the brain that can get "clogged" over time which can be accelerated with smoking (second-hand as well), diabetes, hypertension, hyperlipidemia, etc. This is the pattern that appears.

Now if the MRI of the spine shows something, that pattern could be somewhat indicative of demyelinating disease (not "exterminating" I believe). Then you will need the rest of the work up for Multiple sclerosis which would mean a lumbar puncture (also known colloquially as a "spinal tap")
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What Does The MRI Show?

Well the area of problem you are describing -- the left trunk area and left leg -- would not really fit into a lesion in the brain so it s good he ordered and MRI of the spine. If the thoracic and lumbar are normal, you should still have an MRI of the cervical spine. Regarding the current MRI results -- over the last 3-4 decades that MRI has been around, many patterns have been seen and studied. Chronic small vessel ischemic changes are like having plaque in the brain in parts that usually don t manifest clinically. There are lots of tiny blood vessels in the brain that can get clogged over time which can be accelerated with smoking (second-hand as well), diabetes, hypertension, hyperlipidemia, etc. This is the pattern that appears. Now if the MRI of the spine shows something, that pattern could be somewhat indicative of demyelinating disease (not exterminating I believe). Then you will need the rest of the work up for Multiple sclerosis which would mean a lumbar puncture (also known colloquially as a spinal tap )