Rizzo could you help plz

Hope you can shed some light and anyone else welcome to comment. Here goes lol.

bilateral periventricular white matter changes with small new area change around posterior aspect of left ventricle. Wedge shaped areas of high signal white matter change within the left periventricular white matter adjacent to the left lateral ventricle.

New area around posterior aspect left lateral ventricle. Small change right lateral ventricle, further area of high signal change along posterior horn of left internal capsule.

These areas are hyperintense on T1.

Any form of interpretation please

sonia x


Sorry for the delay! I missed this somehow.

The ventricles are the lakes of CSF in the middle of the brain. Periventricular means next to the ventricles.

“bilateral periventricular white matter changes with small new area change around posterior aspect of left ventricle” means that there are there are abnormalities next to the ventricles on both sides of the brain, with a new bit at the back of the ventricle in the left half of the brain.

“Wedge shaped areas of high signal white matter change within the left periventricular white matter adjacent to the left lateral ventricle” means wedge shaped white spots next to the ventricle in the left half of the brain.

“New area around posterior aspect left lateral ventricle” is just a repeat.

“Small change right lateral ventricle” means a small abnormal area in?/next to? the ventricle in the right half of the brain. I’d guess next to - the radiologist has probably just missed it off.

“further area of high signal change along posterior horn of left internal capsule.” means a white spot towards the back of the brain matter between the top end and the bottom end of the left ventricle (have a look here to see what I mean: http://www.google.co.uk/imgres?imgurl=http://chestofbooks.com/health/anatomy/Human-Body-Construction/images/Fig-37-Horizontal-section-of-the-brain-showing-the-inte.jpg&imgrefurl=http://chestofbooks.com/health/anatomy/Human-Body-Construction/The-Circulation-Of-The-Brain-Part-3.html&h=411&w=500&sz=15&tbnid=UlodZI5GpLBkyM:&tbnh=90&tbnw=109&prev=/search%3Fq%3Dinternal%2Bcapsule%26tbm%3Disch%26tbo%3Du&zoom=1&q=internal+capsule&docid=imW3wP2bsfdwyM&sa=X&ei=5oKrT8rlCZDA8QP4uKmSAQ&ved=0CHcQ9QEwBg&dur=4069)

“These areas are hyperintense on T1.” Are you sure you got this right? I would expect to see “hypointense on T1” or “hyperintense on T2” or “hyperintense on gadolinium-enhanced T1”. Hypointense on T1 is a “black hole” - an area of the brain that has died :frowning: Hyperintense on T2 is a lesion. Hyperintense on gad-T1 is an active lesion.

What does it mean? In terms of MS, periventricular lesions are supporting evidence, however even if everything else is consistent, these lesions are all in the same “MS-typical” area and so don’t meet the dissemination in space criterion in which case, in theory anyway, the best a neuro can do is diagnose “probable MS”. There are also other causes of periventricular lesions, so the neuro may not be able to hone in on MS. I guess the outcome will depend heavily on what your history, clinical exam results and other test results are.


Karen x

Thank you Rizzo, re the are you sure bit it says exactly These areas are hyperintense on T1 and show no enhancement on post gad.

Thank you again

sonia x

I’ve not come across T1 hyperintensities in MS before so went and had a wee look on-line: apparently chronic MS lesions can look like this - well, you learn something every day! I do find it a bit surprising that someone who is only just looking to be diagnosed would have multiple chronic lesions (i.e. established, lacking in inflammatory signs as well as not enhancing with gadolinium) but then I am not a radiologist and I absolutely don’t know it all!

Btw, the paper I got the info about T1 hyperintensities goes through seven different cause categories. You can read the abstract here: Spontaneously T1-hyperintense lesions of the brain on MRI: a pictorial review - PubMed.

Please let me know what the neuro says??

I hope you don’t have to wait too long for some (proper!) answers.

Karen x

Thanks again, I’ve spoke to neuro on phone but language barrier makes it hard to understand all. He has agreed to do the LP on a reduced dose of warfarin as i would be too scared to come off it. Chasing him has been put on hold atm as i am experiencing very bad anti social behaviour where i live so must fight to get moved. The council lady was in the room when the neuro rang and has handed me a medical assessment form as my right side seems to be weakening more than it used to. Stroke at 19 affected my right side but not felt this weak in years. I’m on a walkway so quite a distance from my car.

To top it all off my dad had a heart attack wednesday, i’m so washed out with it all and this stress is probably exagerating my weakness.

Sorry to ramble and thank you for looking into this for me, i will post when i know more about what the neuro thinks,

sonia x

So sorry about your dad. It’s amazing what they can do for hearts these days though, so hopefully he will be fine. You could certainly do without bad neighbours too :frowning:

Remember that I am completely unqualified, but I was thinking that perhaps you should get a neuroradiologist’s opinion on your MRI before you get the LP? I’m saying this because hyperintense T1 periventricular lesions can be caused by stroke so it might not be a great idea to change your warfarin dose, just in case? I could be completely and utterly wrong here though - hopefully your neuro will be able to guide you (once you get over the language barrier!).


Thanks Karen i will try and dig some more info out of the Neuro. I appreciate your translation but by any means would not quote you as i asked for it. I am a very nosy person when it comes to my health and value your opinion greatly as it gives me focus for questions that i might not have considered. All input greatly recieved. Dad might be off to Coventry university so only 40 mins away as this op is last chance saloon : (.

Thanks again you are a real star

Sonia x

Just wanted to say best wishes to your dad. My gramps had a triple heart bypass about ten years before he died (death not heart related). Docs said his heart was still strong as an ox right up to the end. My thoughts are with you.



Thanks midnightmoon, just want it over and done so i can rest

sonia x

Hi Sonia just want to say I hope your dad is ok. Remember to take care of yourself as well Xx

Thankyou nikkinakkinoo, i’m just so tired and

Sonia x