Brain MRI results

New diagnosis and before diagnosis
1

Hi All,

received my MRI (T1.5) results today at GP. All clear according to him.

It reads:

Note is made of some ‘capping’ of the frontal horns of the lateral ventricles. This is slightly asymmetric but entirely non-specific and may be within normal limits.

The brain parenchyma has normal appearance elsewhere. No intra or axtra axial mass lesions. Normal appearance of the posterior fossa.

GP thinks the first sentence is a red herring and probably some ‘technical artefact’ - nothing to worry about (but what causes ‘capping’ and is it deadly!!!). He said it certainly wouldn’t be linked to my paraesthesia symptoms which have a ‘stocking glove’ type presentation and wouldn’t relate to that area of the brain.

He is referring me to a neurologist who will organise nerve conduction tests etc I guess.

I started to talk to him about my reading up on peripheral neuropathy and that one study showed almost 40% of those presenting with peripheral neuropathy had impaired glucose tolerance tests which put them more at risk of going on to develop diabetes. He then checked my blood sugar tests and realised he hadn’t ordered any! So, I’m being sent for a Glucose Tolerance Test and also an auto-antibody screen (i have some joint pain in ankle and big toes) and Lyme serology. I read yesterday that only 300 people were diagnosed with Lyme disease in the UK last year. It is on the increase but still very rare.

I’ve asked him to copy me into all correspondence. He’s a nice bloke but no one is as interested as I am! I feel i completely have to keep on top of this or it will take years and I’ll be passed from pillar to post just like so many others. I’m now going back for more bloods (3rd visit) and I could have had the lot done in one go. NHS staged rationing or incompetence?

My energy is better over the last week and I did a slow 30mins on stationary bike yesterday. Legs felt like jelly when i finished. Burning in soles of feet is getting worse though - still only a 4 out of 10 for pain. Muscle fasciculations in legs annoying.

I would interested in any thoughts on this

Best,

Alan

x

2

I’ll try and explain “capping”:

The lateral ventricles are the reservoirs of CSF in the brain. When you look at MR images, the ventricles look like holes in the middle of the brain. If you slice the brain from the front to the back of the head, through both ears, the ventricles look a little like a butterfly in the middle of the brain. When you look at the ventricles in that orientation, you can see that there are either black or white bits at the tips of the “wings” of the “butterfly”. (They are black or white depending on what type of scan produced the image.) These bits at the tips are what the radiologist has referred to as “capping”.

It’s normal to have these bits, but it’s not normal for them to be too big. (They are often bigger than they should be in MS.)

If your problems are mainly legs and fasciculations, then you’re probably more likely to find something going on in the spine.

Good luck with the tests - and keep being interested - it’s sometimes the only thing that prods the medics into doing what they should!

Karen x

3

Thanks Karen - Ah the pretty bits you see on medical/police programmes when theyn show MRIs and so capping is normal! Just found an article from an american journal on asymmetry in frontal horns

http://www.ajronline.org/content/178/1/240.1.full.pdf+html

They retrospectively reviewed 76 ‘non-neuro’ patients brain MRI’s and found 30 to have asymmetry and patients didn’t come back at 6 months. Their conclusion is that asymmetry without any other major problem is normal.

Sarah - I’ll race you to the diagnosis finishing line? Not that I’m competative or anything - not much…Marathon more than i sprint I feel. Please do PM me - it might be helpful to compare notes.

Best,

Alan

x

4

oh, PG this is the same thread as the last one lol