Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Does Diffuse And Extensive White Matter Signal Abnormality Mentioned In An MRI Scan Require Immediate Attention?
Question: I recently participated in a paid psychological study that included an MRI, and I elected to have a radiologist review the MRI.
This was a Research MRI - NOT a Medical MRI. The scan was done on a SIEMANS PRISMA 3.0T. The radiologist's report states:
"Diffuse and extensive white matter signal abnormality, correlate with subject history of any demyelinating or vascular disease. Cerebral volume loss. Please see your doctor about this report."
Of course I immediately scheduled an appointment with my primary care doctor, who I assume will refer me to a neurologist for further testing - but meanwhile I am absolutely sick with worry! I have so many people who depend on me.
I am 50 years old and have ABSOLUTELY NO SYMPTOMS of cognitive decline - in fact, I work in a very intellectually demanding job, am very busy and active, walk 2-3 miles a day, and in otherwise great health.
I do have a history of minor hypertension which is under control with diuretics, and a history of tension and hormonal headaches - but not migraines. About 20 years ago I had half my thyroid removed due to benign toxic nodule but my thyroid levels are normal.
I have just spent way too much time online taking multiple memory and IQ tests and all show me to have high cognitive functioning, "little to no" indication of dementia, etc...
I do know that cerebral volume loss occurs in many people with age, so am not as alarmed by that - but everything I read about “diffuse and extensive” “white matter signal abnormality" seems very, very bad - White Matter Disease, Small Vessel Disease, AD, Vascular Dementia, etc.
While waiting to see a neurologist, I am just looking for *some* reassurance that this doesn't mean that inevitable dementia is in my future.
Does "diffuse and extensive" mean the same as "severe"? If so, how could I have this and have no symptoms? Can a *research* MRI have a false positive reading of white matter abnormalities?
This was a Research MRI - NOT a Medical MRI. The scan was done on a SIEMANS PRISMA 3.0T. The radiologist's report states:
"Diffuse and extensive white matter signal abnormality, correlate with subject history of any demyelinating or vascular disease. Cerebral volume loss. Please see your doctor about this report."
Of course I immediately scheduled an appointment with my primary care doctor, who I assume will refer me to a neurologist for further testing - but meanwhile I am absolutely sick with worry! I have so many people who depend on me.
I am 50 years old and have ABSOLUTELY NO SYMPTOMS of cognitive decline - in fact, I work in a very intellectually demanding job, am very busy and active, walk 2-3 miles a day, and in otherwise great health.
I do have a history of minor hypertension which is under control with diuretics, and a history of tension and hormonal headaches - but not migraines. About 20 years ago I had half my thyroid removed due to benign toxic nodule but my thyroid levels are normal.
I have just spent way too much time online taking multiple memory and IQ tests and all show me to have high cognitive functioning, "little to no" indication of dementia, etc...
I do know that cerebral volume loss occurs in many people with age, so am not as alarmed by that - but everything I read about “diffuse and extensive” “white matter signal abnormality" seems very, very bad - White Matter Disease, Small Vessel Disease, AD, Vascular Dementia, etc.
While waiting to see a neurologist, I am just looking for *some* reassurance that this doesn't mean that inevitable dementia is in my future.
Does "diffuse and extensive" mean the same as "severe"? If so, how could I have this and have no symptoms? Can a *research* MRI have a false positive reading of white matter abnormalities?
Brief Answer:
White matter disease
Detailed Answer:
Hello,
Thank you for trusting us with your health concern
The white matter degenerative changes are collectively called white matter disease, which can occur as age related changes and vascular issues affecting brain (like tiny strokes). These changes will not necessarily cause any symptoms in an individual as in your case. However, over time if the disease progress, there is a risk of developing issues with memory, cognition, motor skills and balance even though this cannot be considered 'inevitable'.
The MRI done for your research study cannot be considered false positive. I recommended getting another MRI done with T2 flair to get a better picture of the white matter.
'Diffuse and extensive' changes in the MRI is indication that larger areas of brain are affected.
There is no cure as such for white matter disease. However, further disease progression can be prevented by maintaining good vascular health. This can be achieved through maintaining normal blood pressure, blood sugar and cholesterol levels. Taking statins to control cholesterol levels if needed. Taking daily aspirin. Exercise daily and follow healthy diet. Avoid smoking.
Please be advised to follow up with your neurologist for necessary evaluation.
Hope this answers your question
Please let me know if you need further clarification
Regards
Dr.Lekshmi
White matter disease
Detailed Answer:
Hello,
Thank you for trusting us with your health concern
The white matter degenerative changes are collectively called white matter disease, which can occur as age related changes and vascular issues affecting brain (like tiny strokes). These changes will not necessarily cause any symptoms in an individual as in your case. However, over time if the disease progress, there is a risk of developing issues with memory, cognition, motor skills and balance even though this cannot be considered 'inevitable'.
The MRI done for your research study cannot be considered false positive. I recommended getting another MRI done with T2 flair to get a better picture of the white matter.
'Diffuse and extensive' changes in the MRI is indication that larger areas of brain are affected.
There is no cure as such for white matter disease. However, further disease progression can be prevented by maintaining good vascular health. This can be achieved through maintaining normal blood pressure, blood sugar and cholesterol levels. Taking statins to control cholesterol levels if needed. Taking daily aspirin. Exercise daily and follow healthy diet. Avoid smoking.
Please be advised to follow up with your neurologist for necessary evaluation.
Hope this answers your question
Please let me know if you need further clarification
Regards
Dr.Lekshmi
Above answer was peer-reviewed by :
Dr. Kampana
Thank you, Dr. Can you explain the meaning of "diffuse"? Is "diffuse" in contrast to "focal"? Is a "diffuse white matter signal abnormality" actually a *lesion*? Or is it more like a general area, less-intense area of abnormality?
Brief Answer:
Answer detailed below
Detailed Answer:
Hello again,
You are absolutely right. Diffuse and extensive means a larger area of the brain white matter is affected.
Age-related and vascular changes usually cause such diffuse pattern in the MRI scan. T2 weighted MRI will give a clearer picture of the underlying pathology.
Regards
Dr.Lekshmi
Answer detailed below
Detailed Answer:
Hello again,
You are absolutely right. Diffuse and extensive means a larger area of the brain white matter is affected.
Age-related and vascular changes usually cause such diffuse pattern in the MRI scan. T2 weighted MRI will give a clearer picture of the underlying pathology.
Regards
Dr.Lekshmi
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
