Black Hole Lesion?

[mgoerke]

Hi all,

So I've just spent some time reading my MRI reports over the last year. This is in lieu of doing my job which just seems too confusing and overwhelming at the moment.

Anyway, I noted that I have a black hole lesion in my brain. I looked up what that is and understand that it means dead axion...basically dead cells.

What is worrying me is that I read in the SPMS section of the forum that one of the ways to know if you have SPMS or PPMS is black hole lesions. Sometimes knowledge is a bad thing, LOL.

So....do you RRMS'ers have black hole lesions????

Thanks!

[Waydwnsouth1]

Well I have black hole lesions and I am RRMS. I may be wrong but I think it is your level of disability that determines progression and not lesion count or type of lesion. Maybe someone else will post and clear that up but that is my understanding.

[lukeduke]

When I was DX'd way back in the dark ages of 2006, the neuro said I had black hole lesions in my brain. That attack was the first attack I had had that I knew of so I would say that RRMSers get black hole lesions too.

[Windwalker]

If it's any consolation...

I have PPMS for over 10 years. My last Brain MRI was recently...December 2010.

No black hole lesions, no atrophy and brain mass totally normal. There are several lesions but they are small.

[0485c10]

I think if you read the details it says SP_MS has more lesions & bh than people with RRMS. I too had a BH on diagnosis. I'm RRMS.

FYI---3 types of BH lesions...

Active BH - these are lesions that would enhance with the dye on a T1 MRI scan but they show dark on a T1 scan when dye is not used. they are just active lesions.

PersistentBH - these are lesions that show dark on an T1 MRI scan even with the dye.

Permanent BH- Persistent BH that have remained for at least 6 months. Persistent BH can heal and go away, Permanent BH are thought to be permenant..it takes at least 6 months to determine that.

a BH shows dark on a T1 mri scan but it shows a hyperintense bright lesion on a T2 MRI scan.

So a BH shows on both a T1 & T2 scan. It shows as a bright spot on the T2 MRI, and a dark spot on a t1 scan. The 2 MRI (t1&t2) have to be compared and show dark on the T1 scan with a corresponding bright spot on a t2 MRI.

Dark spots on a t2 mri scan are thought to be from mineral(iron) deposits..

On a T1 & Flair MRI the cerebral fluid shows dark. On a t2 mri the cerebral fluid shows as white.

My concern is that you are reading your MRI yourself and there are a lot of anatomical structures of the brain that are normally dark. Without knowledge of reading its possible you are confusing a a normal anatomical structure as a BH?. Are you comparing both T1 w/dye and T2 MRI at the same location shows a bright lesion & a dark lesion?

If not you might be scaring your self somewhat, bring the subject up with your doc. And i think its people with SP have a greater lesion load and MORE BH. Not that either one indicates SP. SP is very tough to distinguish.

funny story-when i first looked at my spine mri it was all white. i thought my entire spine was in a relapse even though i was not symptomatic for a spine lesion. thats when i learned how the cerbralfluid surrounding the spine shows with on a t2 mri scan.

scared myself silly before i finally realized the cerebral fluid shows different colors on the 2 mri's. LOL

[floatingurboat]

I was told I have "too many lesions to count" and a lovely little black hole in my cerebellum, however I'm RRMS - so I'm not exactly sure what the criteria is for SPMS or PPMS but I'm pretty sure it's not solely based on whether or not you have a black hole or a large amount of lesions. Try not to worry too much, easier said than done I'll admit, but worrying will just make you sicker in the long run.

[deb46]

I too have a black hole. My mri report didn't mention. I always get copies of my mri's and I saw the whole. Took them to my neuro and she confirmed the black hole. That has been about 4 years ago.