MRI results today. Pretty scared.

[SherryBerry72]

Had brain and c-spine MRI last Friday. Dr's office called yesterday to tell me my c-spine was perfectly normal. I questioned the brain and she looked and said she did not has them. To get to the point, they called today. Everything was normal except for this:

Several small areas if increased T2 and flair signal in the periventricular and subcortical white matter are demonstrated consistent with small vessel ischemic changes.

The nurse gave me that information on the phone (as well as faxed it) and she said the doctor said, "MS has not been ruled out." I went into a full body cold sensation....a slight panic.

Last MRI in 2006 was normal and all neuro exams have alway been normal....so I was really hoping....this would be normal again.

Any thoughts?

[MarkLavelle]

"Consistent with small vessel ischemic changes" is not what it would say if the radiologist thought the signals looked like MS lesions, and a thorough neuro will generally not say MS has been ruled out unless they've found a different cause for your sx.

It sounds to me like your neuro will be doing additional testing...

[22cyclist]

Mark is right. MS lesions look a certain way and go to certain places. Your lesions seem to be too small to be considered MS. That is why they say "small vessel disease". If your neurologist has not ruled out MS, you will need more testing like evoked potentials, LP, etc.

I hope all goes well for you. Try not to stress too much!

Take care
Lisa

[SherryBerry72]

Lesions

Would these "flair signals" be considered lesions...or could it be other things as well?

The radiologist's report summarizes with:

"Small vessel ischemic changes, but no evidence of increased intracranial pressure, mass or significant encephalomalicia. Cerebelloontine angle structures are normal."

So it appears to be "vessels."

He did not add anything about MS, my dr (GP) is the one who said, "MS was not ruled out." That was her endnote to the nurse who called me.

Either way, when it's your brain, it's scary.

[MSer102]

Would these "flair signals" be considered lesions...or could it be other things as well?

The word "lesion" means something that isn't supposed to be there or something that doesn't look like it should. A zit on your nose is a lesion.

Small vessel ischemic changes means tiny areas of damage cause by lack of blood flow in those parts of the brain. Ischemia is not MS.

MS damage (lesions) has a particular way it looks. If damage looks like it might be caused by MS the radiology report usually includes a statement like, "a demyelinating process cannot be ruled out" or "possible etiologies include X, X and multiple sclerosis". Your radiology report apparently doesn't include any statements that even suggest MS or demyelination.

"Small vessel ischemic changes" is fairly specific as to suspected cause. However that's just a radiology report. MS isn't diagnosed based only on an MRI.

Your GP is probably not in a position to know whether MS should or shouldn't be ruled out at this point. But as long as your GP hasn't run all of the tests and isn't qualified to be able to rule out MS, the possibility is still open. Your GP has your entire history and some other test results. So your GP is in a better position to say that "MS has not been ruled out" than the radiologist, who is making a statement only about the appearance of your MRI.

For MS to be ruled out, you'll have to see a neurologist.

[SherryBerry72]

Thank you!

Thanks for your replies. They are quite helpful.

I'm kind of terrified one minute, and not in the next. The unknown!!!

Ischemic changes that could be caused by small strokes or God only knows what.....or a chance it could be MS. Not something easy to lay down in bed at night without a fear in your mind and gut. I think that the possible strokes (I'm 41) may be scarier. Laying down not knowing if you have something serious like that going on in your brain while you sleep...no wonder I'm awake at 2:30 a.m. with anxiety.

I know I'm preaching to the choir here!!

[pennstater]

Hi SherryBerry,

Sorry you are so anxious. You nailed it though. The unknown can be scary. I hope you see a neurologist soon so you can start to get answers.

Take care and try not too let the anxiety take over.

[SherryBerry72]

Stress

Yes, stress does me in!!! My symptoms usually ALWAYS start w/ a stressful event and it's generall something to do w/ my x-husband.

I am going to be strong through this. I can't dwell anymore. It's eating me up. My symptoms started in 2002. I had 3 MRIs between 2002 - 2005 - all were normal.

If this one was normal, I planned on finally letting it go. But, wow - this was a slap in the face.

There is nothing my worrying can do to make my "answer" any different...but worrying sure does make me feel bad.

[minnie76]

My first MRI results stated " excessive demyelination for someone of her age group, primary MS and xxx, xxx, ischemic" need to be ruled out.

Neuro looked at my MRI and barely flinched...said it was prob from migraines.

Needless to say, I've been in limbo since Jan 2012. Have had a couple MRI's that are now stable.

When I was at my peek in terms of stress because I didn't know what was causing my symptoms....I will tell you that my symptoms where 100% worse.

My head would buzz and vibrate...I thought I was falling apart...I was soooo scared.

I have now learned to try and manage my stress so my symptoms don't go into overdrive.

The other day I saw a black hole in my vision...had this happened 2 years ago I would have freaked...now I just closed my book and told my self I need to sleep.

Finally going for an evoked potential.

I wish you all the best, and I'm in the same boat as you...when it comes to the brain it does seem pretty scary.

take care, and I hope you get answers soon!

Minnie76

[SherryBerry72]

Final answer?

Went back to neuro today for the 2nd time. Last week he had not yet viewed my MRI himself because it was not in his office until I was about to check out.

The "spots" that the radiologist noted were suspicous to him.....as if to be nothing more than a squiggle that the scan caught when switching frames (or something like that). He showed me two spots - one was on the right...one was on the left - and if you drew a line to from one to the other, it would be a perfectl straight line and the spots were in the same exact spots on each side. They were not quite 1 mm in size and he said they were in a part that would not even cause symptoms.

My last MRI was in 2005 on a 3.0 Tesla machine and nothing was there....it was clear. I saw my brain today and it looked clear.

He said, "There is nothing on this MRI that would remotely relate to MS - you do not have MS!"

My first MRI was in 1996 (due to ringing ears) and that was 2 yrs after being diagnosed w/ Pars Planitis. Second was in 2002 of c-spine (clear), 3rd was in 2004 (brain), 4th was in 2005 (brain) and now....2014 (brain and c-spine)....all checking out fine.

I think I can finally quit worrying about MS. Though my SYMPTOMS have not yet been pin pointed exactly, is it safe to say that all of my MRIs through the years, being clear, that I can quit worrying about MS being the cause? I know it can take a while for things to show up, but it's been almost 20 yrs since my first "issue" that would be related to MS (in small percentages).

[Kimba22]

Though my SYMPTOMS have not yet been pin pointed exactly, is it safe to say that all of my MRIs through the years, being clear, that I can quit worrying about MS being the cause?

I think so. I'm glad to hear there's nothing to indicate you have MS. I hope your doctors figure out what is really causing your symptoms.

I wish you well ...