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Hi, 2 Times I Had Double Vision (both While Playing
Question: Hi, 2 times I had double vision (both while playing video games), that corrected when covering one eye. I was worried about a brain tumor, so I had a private MRI done. The following was analysis of my MRI:
1. No mass or hemorrhage.
2. No acute ischemia.
3. There is an 4 x 2 mm area of abnormal increased signal in the posterior limb of the
right internal capsule best demonstrated on Axial T2 image 11. This probably represent a
small lacunar infarct. Recommend clinical correlation and appropriate follow up.
4. Ethmoid, frontal, and bilateral maxillary sinusitis.
5. The mastoid air cells are essentially clear.
I am very healthy 54 yo, male. I didn't have any noticeable symptoms other than double vision twice. I do get migraines occasionally, that disappear with only Advil.
What I'm concerned about is the "possible" lacunar infarct. I can remember 3 times when I had a severe stabbing like pain in my head... one was in my 20s at the gym when I held my breath while lifting and felt the sharp pain in my head. The other was during intense sexual activity when my whole body tensed up greatly. Other than that, I've had no issues. I supposed it could be a silent lacunar infarct?
Because of my safety sensitive job, I want to keep this discreet, which is why I'm online here.
What is the chance that this area of "increased signal" is not lacunar infarct?
If it were, are there treatments other than diet, keeping low blood pressure,salt intake and cholesterol?
Is there a way to better determine if this is actually a lunar infarct or something else? What else could it be?
Thanks
1. No mass or hemorrhage.
2. No acute ischemia.
3. There is an 4 x 2 mm area of abnormal increased signal in the posterior limb of the
right internal capsule best demonstrated on Axial T2 image 11. This probably represent a
small lacunar infarct. Recommend clinical correlation and appropriate follow up.
4. Ethmoid, frontal, and bilateral maxillary sinusitis.
5. The mastoid air cells are essentially clear.
I am very healthy 54 yo, male. I didn't have any noticeable symptoms other than double vision twice. I do get migraines occasionally, that disappear with only Advil.
What I'm concerned about is the "possible" lacunar infarct. I can remember 3 times when I had a severe stabbing like pain in my head... one was in my 20s at the gym when I held my breath while lifting and felt the sharp pain in my head. The other was during intense sexual activity when my whole body tensed up greatly. Other than that, I've had no issues. I supposed it could be a silent lacunar infarct?
Because of my safety sensitive job, I want to keep this discreet, which is why I'm online here.
What is the chance that this area of "increased signal" is not lacunar infarct?
If it were, are there treatments other than diet, keeping low blood pressure,salt intake and cholesterol?
Is there a way to better determine if this is actually a lunar infarct or something else? What else could it be?
Thanks
Brief Answer:
Further evaluations are necessary, read below.
Detailed Answer:
Hello and welcome to " Ask a Doctor" service.
I have read your query and here is my advice.
The MRI states that there is a possible lacunar infarction, but there is no evidence of acute ischemia, so, chances of this being a silent stroke are very high.
For this purpose, you should be evaluated for the possible cause(s) that, in the majority of the cases, arise from the cardiovascular system.
Cardiac workup for possible thromboembolism and proper evaluation of your neck arteries (carotid and vertebral arteries) are necessary.
Blood tests for cholesterol levels also are necessary.
It also may be sequelae from past migraines, but, the above-mentioned causes should be evaluated properly.
There is sinusitis also that, you should address too by seeing an ENT Doctor.
In the meantime, monitor your blood pressure, eat healthily, and exercise regularly.
I hope this helps.
Feel free to ask if you have further questions.
Further evaluations are necessary, read below.
Detailed Answer:
Hello and welcome to " Ask a Doctor" service.
I have read your query and here is my advice.
The MRI states that there is a possible lacunar infarction, but there is no evidence of acute ischemia, so, chances of this being a silent stroke are very high.
For this purpose, you should be evaluated for the possible cause(s) that, in the majority of the cases, arise from the cardiovascular system.
Cardiac workup for possible thromboembolism and proper evaluation of your neck arteries (carotid and vertebral arteries) are necessary.
Blood tests for cholesterol levels also are necessary.
It also may be sequelae from past migraines, but, the above-mentioned causes should be evaluated properly.
There is sinusitis also that, you should address too by seeing an ENT Doctor.
In the meantime, monitor your blood pressure, eat healthily, and exercise regularly.
I hope this helps.
Feel free to ask if you have further questions.
Above answer was peer-reviewed by :
Dr. Kampana
Answered by
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