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    Please help me with MRI report

    Hello everyone,
    I'm a 52 y.o. woman and I developed symptoms this late winter -- burning sensations, restless legs, tinnitus, jerking when falling asleep. I've had the burning sensations twice before (2011 and 1995) and have had anaphylactic allergic reactions for 20 years.
    First neuro did C-spine MRI which showed pinched nerve. I asked him about MS and I could tell he thought I was hypochondriacal/menopausal.
    "Passed" the neuro exam with second neuro who said I didn't present as MS and most cases are diagnosed before age 50. I asked for brain MRI and she reluctantly agreed to one. Yesterday she called me and told me results were normal. Today I received my copy of the report in mail. It reads: "There are mild scattered punctate foci of T2 such FLAIR hyperintense signal within the cerebral white matter. These lesions are nonspecific in nature and similar findings can be seen in the setting of migraine headaches, gliosis from prior infectious/inflammatory processes, chronic small vessel ischemic change, vasculitis or demyleination. Statistically, these lesions likely reflect chronic small vessel ischemic change in a patient of this age." I've googled these terms, but would appreciate more help. I'm calling the neuro tomorrow. How can this result be "normal"?! Especially given my symptoms.
    I've never had migraines, although this winter I did start waking up with headaches. Also have had periods of depression. Prior to symptoms this winter, I was experiencing panic attacks and depression.
    Sorry to be so long, but I feel really let down by this doctor.
    Thanks in advance for your help

    #2
    They are basically saying that you have had blood pressure changes in your head that have lead to these tiny lesions. Punctate lesions are not like MS lesions which are large and ovoid in shape. Punctate lesions are small and round in shape and generally not in places that MS lesions are found.

    If you feel like they did not read it properly, see an MS specialist and have them take a look. Your symptoms are not very MS like in nature. You have no numbness, weakness or the like. If you passed your neurological exam, that would lead them away from an MS diagnosis, or any other CNS diagnosis.

    As we get older, punctate lesions do invade the brains of some. Ischemic vessel disease could be high or low blood pressure in your brain at any given time. Your cerebral blood pressure is opposite your systemic blood pressure. So if at times you have high blood pressure, you can have low blood pressure in the brain, and vice versa. This can cause part of the vessel to loose oxygen (ischemic) and leave behind a punctate lesion or scar where the disruption of blood flow.

    These are lesions that we do not need to worry about. There are thousands of other blood vessels that the blood can follow to perfuse the brain. So much like those for migraines, the blood flow ignores them and takes the path of least resistance.

    Hope you feel better.

    Lisa
    Moderation Team
    Disabled RN with MS for 14 years
    SPMS EDSS 7.5 Wheelchair (but a racing one)
    Tysabri

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