Can You Please Help Me Understand The Following MRI Report?

Posted on Mon, 29 Apr 2019

Question: Can you please help me understand the following MRI report? This was mostly due to my recent issues with loss of sense of smell. I'm especially worried about "chronic microvascular ischemic changes". What does the report say? What specialist should I visit? Thank you so much for your help. ------- IMPRESSION: Olfactory bulbs/tracts bilaterally appear symmetric and normal in caliber and signal intensity. Mild paranasal sinus disease with mucosal thickening particularly within the ethmoid sinuses. Small left maxillary sinus mucous retention cyst. Subcortical and deep white matter foci of T2 FLAIR signal within the bilateral cerebral hemispheres, nonspecific but likely reflecting chronic microvascular ischemic changes. No acute infarct, intracranial hemorrhage or shift of midline structures.

Answered by Dr. Olgeta Xhufka (3 hours later)

Brief Answer:
See detailed answers below.

Detailed Answer:
Hello dear, welcome to Ask A Doctor service.
I read your query and here is my advice.

This MRI report shows that your olfactory nerve, the nerve of smell, is normal in all his length and in the bulb ( brain part where the nerve starts).

You have mild sinusitis, inflammation of sinnuses.
You also have a mucosal cyst on left sinuses.

All over your brain are microvascular foci which are signs of degenerative chronic disease of the brain. No acute disease like stroke, hemorrhage.

The lack of smell you are suffering from comes as a result of mild congestion of your sinuses also the chronic brain issue.

Hope I have answered the question.
Let me know if I can assist you further.

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Olgeta Xhufka (2 hours later)

Thank you so much for your help, really appreciate it. May I know what can be the possible cause for the degenerative chronic disease? Can it be something like Alzheimer's or MS? I have been dealing with hypertension for close to 15 years (I'm 73 at the moment). Is it normal at this age? Is it something I should be worried about? If it is a cause for concern, may I know what type of specialist do I have to visit, a neurologist? Thanks again

Answered by Dr. Olgeta Xhufka (27 minutes later)

Brief Answer:
Neurologist visit necessary

Detailed Answer:
Hello dear and thank you for asking again.

Some types of degenerative brain disease that cause focal necrosis are, multiple sclerosis, Alzheimer's, dementia, amyotrophic lateral sclerosis, etc...

Sometimes these changes can be related to brain aging process.

It'll be better to visit a Neurologist for confirmation of the exact diagnosis.

Regards

Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.

Above answer was peer-reviewed by : Dr. Arnab Banerjee