Hi, I’ve had a long journey trying to find out what is wrong with me due to the symptoms I’ve been struggling with. I had an MRI in Dec and finally got my results last Thursday from my GP. The Brain MRI results state - small high signal focus within the anterior corpus collosum to the left, and further small periventricular lesions on the right anteriorly could be early demyelinating plaques. I would like to know, what next, my neuro has not yet sent me a letter to have a follow up. Is this similar to other users MRI findings? Could I have MS? What advice do you recommend? Shocked my neuro has had this info for 2 months and not got in touch. Stressed
I can’t tell you for sure what the results mean, but I tell you what they say and what they suggest (please remember that I’m not a radiologist or a neuro though).
The brain has three main parts: the cerebrum (the big bit at the top that most people think of as the brain), the brain stem (the bit that comes out the bottom of the cerebrum and becomes the spinal cord) and the cerebellum (the roundish, wrinkly part underneath the back of the cerebrum and behind the brain stem). The cerebrum has two halves / hemispheres. These are joined by various bits of “white matter” (the connections between different bits of gray matter, the stuff that does the storage, processing, “thinking”). The thickest connection between the two hemispheres is the corpus callosum. It’s a thick bundle of white matter and is very important for letting the left side of the brain know what the right side is doing (and vice versa), so they can work together.
Anterior means towards the front of the brain, so nearer the eyes.
The ventricles are the reservoirs of CSF (cerebrospinal fluid) in the middle of the brain. Peri-ventricular means next to the ventricles.
A “high signal focus” means a white spot with clean edges. White spots are lesions.
You have a small lesion on the front, left side of the thick white matter bundle joining your left and right hemispheres. You also have some small lesions near the front half of your right lateral ventricle. (I’m assuming lateral ventricle - these are the big ventricles near the corpus callosum, in the middle of the cerebrum.)
The radiologist says that they might be demyelinating placques. This means that he thinks they are lesions caused by demyelination, the process most commonly linked with MS in which the immune system wrongly attacks and damages the myelin coating on nerves.
What does this mean? If your symptoms and exam results are consistent, this report would be strongly supportive of an MS, probable MS or CIS diagnosis. The difference between the options firstly depends on how many attacks you have had. Just the one and probable MS or CIS are most likely. More than one and MS or probable MS are most likely, but which one depends on how strictly the neuro sticks to the McDonald criteria. This is because the McDonald criteria state that we need to have lesions in at least two of four areas: periventricular (you have), juxtacortical (you do not have), infratentorial (you do not have) and spinal cord (did you have your spine scanned?). [Fyi, juxtacortical means next to the cortex, the outer layers of gray matter in the cerebrum and infratentorial means in the brain stem or cerebellum.]
Do you have a follow up appointment with the neuro? 2 months silence with a positive scan result seems ridiculous
Hi, thank you for your reply Rizzo, since I last posted i have received a request to go for VEP tests. I still have not had a follow up and now my Neuro is on annual leave for a month. I was just wondering what would be the reason for VEP tests, bearing in mind my first post in this thread. Any help would be great. My test in next Friday. Matt
VEPs test the signals between the eyes and the brain. Different conditions produce different effects. In MS, the signal strength is often normal, but the speed is slower than normal. (This is because MS damages the myelin that helps nerves to send fast signals.)
VEPs is often, but not always, abnormal in people with MS.
A lot of neuros will do VEPs as well as MRI. If both point to MS, then it makes it much more certain.
All the delays seem very unreasonable I’m not sure what can be done however as a new referral’s waiting times may be even longer
MS isn’t considered an emergency as it’s a chronic condition and there is no cure. That doesn’t much help the people waiting on a diagnosis though!