Could anyone explain the following for me please? The Mri of the brain showed greater thickening of Basel meninges compared with previous scan with greater brightness in keeping with early leptomeningeal enhancement. Spinal fluid protein raised at. 0.6 but not significantly so. Many thanks
This is out of my comfort zone so I can’t really tell you very much, sorry. (And please don’t forget, I’m not a radiographer or neuro.)
The leptomeninges are the two inner, protective layers of membranes covering the central nervous system. The report means that these are showing up brighter than expected on your MRI which suggests some abnormal process at work (I can’t say which one though - as far as I know there are multiple possibilities). The basal / basilar meninges are the membranes at the bottom of the brain - yours are thicker than they used to be (which I assume means that whatever is causing your symptoms is still active).
There are various causes of raised protein in CSF so the 0.6 figure doesn’t really say a whole lot.
Hopefully your neuro will be able to combine these results with your history, symptoms and signs and come up with an answer and treatment plan for you.
Karen x
Thanks so much Karen, that’s really helpful I’m seeing the specialist neuro on the 17th dec so will hopefully get some more answers He did end the letter saying a close eye needs to be kept on me and an escalation in treatment. I have neurosarcoid but ms has also been mentioned. I read somewhere that the newer mri scanner’s 3t produce clearer results, there is one local to me and wondering wether it would be worth having it done, Guess I need to ask the neuro. Thanks again Karen
And here was I avoiding saying that, amongst other things, the results you’ve mentioned are found in neurosarcoid!
3T scanners are better at showing up smaller brain lesions, but they still need to be used with decent settings to make the most of this. After all, a Ferrari is no faster than a Fiesta in a 30mph speed limit.
Kx
Thanks so much Karen, Had another letter today which talks about Mri scan shows Areas of high signal are noted in the subcortical white matter of the frontal and parietal lobes bilaterally, in keeping with ischaemic change. ?
“Areas of high signal”: lesions
“subcortical white matter of the frontal and parietal lobes bilaterally”: There are three main types of matter (i.e. “stuff”) in the brain: gray matter, white matter and cerebrospinal fluid (CSF). The gray matter does all the encoding, processing, storage, etc (basically the “thinking”). The white matter carries the signals between different parts of gray matter (like telephone lines). The CSF is fluid that works a little like oil in an engine. The brain has three main parts: the biggest bit (that most people think of as the brain) is the cerebrum, the brain stem (which joins up with the spinal cord) and the cerebellum (the oval part that lies underneath the back of the cerebrum and behind the brain stem). The cerebrum has two hemispheres (halves), each containing four main lobes (areas): frontal (at the front), parietal (behind the frontal lobes at the top of your head), temporal (behind the frontal lobes, but lower than the parietal; behind your ears), occipital (at the back). If something is in one half of the brain, it is called unilateral. If it is in both, it is called bilateral. The outer layers of the cerebrum are made up of gray matter - this is referred to as the cortex. Underneath this is white matter. White matter lying close to the cortex is called subcortical. White matter lying deeper into the brain is called deep white matter. So your lesions are in both sides of your brain, in the frontal and parietal white matter close to the cortex.
“in keeping with ischaemic change”: the lesions have the appearance and are in the locations that would be expected of changes caused by problems with blood supply.
Hope that makes sense!
Kx
Thanks so much Karenx