Confusion on size of lesions and phase???

[from2344]

I have a question and I have done research on it but I am still very confused and was hoping someone here could explain it to me please.

I have 8 lesions one is in c spine and other 7 in brain. My mri report states that 2 of the lesions are "most likely in a sub-acute phase" also stated is that of the 8 lesions the largest measures 7 mm.

What I am finding confusing is that it sounds like a sub-acute phase is when your body is regenerating and trying to heal itself but if so then why is it explained as a negative thing happening?

Also, I read that 80% of lesions are between 7-10 mm and the larger they are the better that is. I am not understanding why having smaller lesions would be a more harmful then to having larger lesions. From what I am understanding lesions will also shrink over time.

I hope that any of this makes sense to someone I am so confused I am not even sure if I am getting across what I am trying to ask lol.

[rdmc]

I have a question and I have done research on it but I am still very confused and was hoping someone here could explain it to me please.

I have 8 lesions one is in c spine and other 7 in brain. My mri report states that 2 of the lesions are "most likely in a sub-acute phase" also stated is that of the 8 lesions the largest measures 7 mm.

What I am finding confusing is that it sounds like a sub-acute phase is when your body is regenerating and trying to heal itself but if so then why is it explained as a negative thing happening?

Also, I read that 80% of lesions are between 7-10 mm and the larger they are the better that is. I am not understanding why having smaller lesions would be a more harmful then to having larger lesions. From what I am understanding lesions will also shrink over time.

I hope that any of this makes sense to someone I am so confused I am not even sure if I am getting across what I am trying to ask lol.

Hi From, sorry you haven't gotten any replies, and I hope bumping this to the top of the page gets you more feedback.

I've never heard that smaller lesions cause more trouble than larger ones. I have heard rhat location of the lesions defines what type of disease activity we have.

I have a link to a video of a man who has RRMS and researchers did an MRI every couple of weeks, and although he has lesions coming and going, he had no relapses.

As to size, I think they can be any size, but usually about 3 to 7 mm, and as I said before location matters. I have a 9 mm lesion but in an area of the brain that is relatively small, so that one lesion causes several different symptoms.

still lesion location and size is not an indicator of prognosis. Maybe more folks will chime in who are more knowledgable than me.

[Marco]

I have 8 lesions one is in c spine and other 7 in brain. My mri report states that 2 of the lesions are "most likely in a sub-acute phase" also stated is that of the 8 lesions the largest measures 7 mm.

What I am finding confusing is that it sounds like a sub-acute phase is when your body is regenerating and trying to heal itself but if so then why is it explained as a negative thing happening?

I read that slightly differently than you do. The fact that you had current or recent activity is "negative" not that your body is trying to recover from it. I equate it to having a car wreck with no injuries. It's great there were no injuries, but it's sad or "negative" you were in an car wreck to begin with.

Lesion location determines what, if any, area of function will be impacted. So while location is important, bigger lesions do correspond to more brain damage. I've never heard the bigger the lesion is the better it is for you. That sounds counter-intuitive to me, but I too have extra holes in my head. Lesions may or may not heal over time depending on the damage that was done and your bodies ability to heal. Black holes represent areas of deeper lesion where the axon and nerve was damaged during demyenlination. Black holes have been shown to heal in rare cases (scientists don't know why). White areas typically represent places where water has replaced fat in the brain.

[22cyclist]

I have a question and I have done research on it but I am still very confused and was hoping someone here could explain it to me please.

I have 8 lesions one is in c spine and other 7 in brain. My mri report states that 2 of the lesions are "most likely in a sub-acute phase" also stated is that of the 8 lesions the largest measures 7 mm.

What I am finding confusing is that it sounds like a sub-acute phase is when your body is regenerating and trying to heal itself but if so then why is it explained as a negative thing happening?

Also, I read that 80% of lesions are between 7-10 mm and the larger they are the better that is. I am not understanding why having smaller lesions would be a more harmful then to having larger lesions. From what I am understanding lesions will also shrink over time.

I hope that any of this makes sense to someone I am so confused I am not even sure if I am getting across what I am trying to ask lol.

I think both people here have given good advice. When they say "sub acute phase" that means not yet active or perhaps never have been active.

Smaller lesions are not more lethal than bigger ones, like someone said, it depends on the location, and the bigger the lesion, the more brain damage it causes depending on the location.

Not all lesions will shrink over time. I mean, that would be great, but it just doesn't work that way. Some do, some disappear altogether, some get bigger. Everyones brain is different.

So, as far as lesions go, your lesion in your C-spine, is not a good place to have one. If you have any in your brainstem, that is another bad place to have them. Also your cerebellum, your optic nerves, and temporal lobe.

I hope yours are not in any of these places and you will get on a medication that slows your progression soon (if you are not already one).

Take care
Lisa

[Thinkimjob]

Location, location etc. It is my humble, non-doctorial opinion, that the vast bulk of us wind up with spinal lesions, which is when I think secondary progressive MS eventually sets in.

Whatever this sucker is, it usually wends it way down.

On the plus side, (yay) this can take many, many years.

On the bluck side, well, bluck. The positive happily clapping side of me is glad I've had all this time, no matter how stuffed I've been for the last few years.

The negative miserable side thinks, why didn't I just cark it? I had my chance, brain haemorrhage, so there must be a reason why I'm still here.

(Or just a really good neuroradiologist. )

[sardi_g]

"Larger lesions showed longer subacute phases but disproportionally more recovery. Patients with smaller average peak lesion size showed trends toward greater disability and proportional residual damage."

Great... I have gobs of tiny lesions. Although I do have large ones on my spinal cord - probly the last place you want large lesions - increased recovery or not.

This is an oldish article - 2007 - and nobody here has mentioned this so hopefully it doesn't has much weight but I'd like to hear someone prove me wrong.
http://www.ajnr.org/content/28/10/1956.long

[sardi_g]

Wait, I misspoke. I meant I'd like to hear contradictory information regarding the article. I don't mean prove me wrong that this is an oldish article with outdated info. In that regard prove me right!

[MrsBones]

Wait, I misspoke. I meant I'd like to hear contradictory information regarding the article. I don't mean prove me wrong that this is an oldish article with outdated info. In that regard prove me right!

From the conclusion of the article you posted:

CONCLUSION: Smaller lesions appeared disproportionally more damaging than larger lesions, with lesions in progressive MS smaller and of shorter activity than in relapsing-remitting MS. Associations of lesion dynamics with rates of atrophy and disability and clinical subtype suggest that changes in lesion dynamics may represent a shift from inflammatory toward degenerative disease activity and greater proximity to a progressive stage, possibly allowing staging of the progression of MS earlier, before atrophy or disability develops.

The study, done on 40 patients, was an effort to find a potential marker to determine transition from RRMS to SPMS. they determined that in those with progressive MS, the lesions tended to be smaller, active for a shorter period and so on. They don't appear to be saying that as a general rule, just that in the 40 people they studied, it was a difference between the progressive and relapsing MS patients and therefore, could possibly be used to guess, from changes in an individual's lesion formation patterns, when they are going from RRMS to SPMS.

As others have said, lesions come in all shapes and sizes in all types of MS. Many, many people start with lesions that are small and almost asymptomatic. I have PRMS and started with numerous lesions of varying sizes. Some have grown, some disappeared, I developed a black hole and a few confluent lesions. My confluent lesions were far less troublesome when they were small, separate lesions then they are now that they've grown together.