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I'm Reading My Identical Twin Sister's MRI Results . She
Question: I'm reading my identical twin sister's MRI results . She fell and hit the back of her head so she went for an MRI. It showed the ventricles and sulk are prominent consistent with a moderate degree of volume loss.Disaproptionate dilation of the lateral, third and forth ventricles is noted which could be related to a component of central volume loss. Mild communicating hydrocephalus could also produce this appearance in the proper clinical setting. There is no midline shift. Itchy flair signal abnormality is noted in the periventricular and subcortical white matter and in the central pones. She is seeing a neurophysoligist today. I am a nervous, since she fell on her head this happened. She is on blood pressure pills meteprolod and losartin.
I'm reading my identical twin sister's MRI results . She fell and hit the back of her head so she went for an MRI. It showed the ventricles and sulk are prominent consistent with a moderate degree of volume loss.Disaproptionate dilation of the lateral, third and forth ventricles is noted which could be related to a component of central volume loss. Mild communicating hydrocephalus could also produce this appearance in the proper clinical setting. There is no midline shift. Itchy flair signal abnormality is noted in the periventricular and subcortical white matter and in the central pones. She is seeing a neurophysoligist today. I am a nervous, since she fell on her head this happened. She is on blood pressure pills meteprolod and losartin.
Brief Answer:
Evaluation is needed, but no reason for panic.
Detailed Answer:
I read your question carefully and I understand your concern.
First of all I would like to precise that those changes found on the MRI are of a chronic nature. There is no acute lesion, there is no damage sustained from that fall and there isn't any finding indicating an acutely threatening issue requiring immediate intervention.
The first part describes some volume loss. Some volume loss is expected. All of us from our thirties start losing some brain cells and as a result the brain volume is diminished year after year, to a point it is a part of aging. In the first decades these loses aren't noticed on MRIs, but as the years go on as cell loss accumulates it becomes visible. So some degree of volume loss is expected in a patient 78 years old. Usually it's described as mild, moderate or severe. The more pronounced it is, the higher the concern that it is not only due to aging but to dementia (though there isn't an exact correlation, one might have pronounced changes without manifestations of dementia, it aids in the diagnosis but it is the clinical manifesations which matter most). In this case it speaks of moderate changes which certainly do not necessarily indicate dementia and could be normal for her age. It is only if there is proof of impairment of cognitive functions like memory, language, judment etc that a diagnosis of dementia is done. So those neuropsychological tests are more meaningful in that regard than some volume loss.
The next section of the report deals with the fact that these changes are more pronounced in the central part of the brain, making for the appearance of enlarged ventricles (the fluid filled spaces inside the brain). This may be due to neurodegenerative changes like Alzheimers (for which as I said neuropsychological tests are more indicative), but it recalls the attention of the clinician that it may be also due to hydrocephalus, in particular normal pressure hydrocephalus. So the examining neurologist must evaluate whether there are any indications of hydrocephalus commonly manifesting in addition to dementia with gait impairment and urinary incontinence. If there are such manifestations a lumbar puncture may also be needed for the diagnosis.
The last part describes the changes noted in the white matter and pons. These changes refer to small vessel disease, diffuse changes of the smallest blood vessels. Again these changes are chronic occurring over many years and are commonly found with age. Some changes are again to be found at the age of 78. It is a little difficult to evaluate how advanced these changes are (whether corresponding to her age or too advanced) as the radiologist hasn't given any information regarding their scale (usually there is a severity scale used), not even with simple terms like mild, moderate or severe, so I am afraid it is hard for me to assess that, I can only say that some mild changes are common after the age of 65, so not necessarily worrying. Conditions like high blood pressure increase the chances of such changes to small blood vessels.
So to resume those changes must be cautiously interpreted in correlation with the clinical findings, not alone. They do raise the concern for the possibility of dementia (which may be due to many causes like Alzheimer's, hydrocephalus or also advanced small vessel disease), so evaluation is needed, but only if there are additional clinical manifestations and changes on neuropsychological tests are those MRI changes meaningful, otherwise they might be simply part of aging.
Evaluation is needed, but no reason for panic.
Detailed Answer:
I read your question carefully and I understand your concern.
First of all I would like to precise that those changes found on the MRI are of a chronic nature. There is no acute lesion, there is no damage sustained from that fall and there isn't any finding indicating an acutely threatening issue requiring immediate intervention.
The first part describes some volume loss. Some volume loss is expected. All of us from our thirties start losing some brain cells and as a result the brain volume is diminished year after year, to a point it is a part of aging. In the first decades these loses aren't noticed on MRIs, but as the years go on as cell loss accumulates it becomes visible. So some degree of volume loss is expected in a patient 78 years old. Usually it's described as mild, moderate or severe. The more pronounced it is, the higher the concern that it is not only due to aging but to dementia (though there isn't an exact correlation, one might have pronounced changes without manifestations of dementia, it aids in the diagnosis but it is the clinical manifesations which matter most). In this case it speaks of moderate changes which certainly do not necessarily indicate dementia and could be normal for her age. It is only if there is proof of impairment of cognitive functions like memory, language, judment etc that a diagnosis of dementia is done. So those neuropsychological tests are more meaningful in that regard than some volume loss.
The next section of the report deals with the fact that these changes are more pronounced in the central part of the brain, making for the appearance of enlarged ventricles (the fluid filled spaces inside the brain). This may be due to neurodegenerative changes like Alzheimers (for which as I said neuropsychological tests are more indicative), but it recalls the attention of the clinician that it may be also due to hydrocephalus, in particular normal pressure hydrocephalus. So the examining neurologist must evaluate whether there are any indications of hydrocephalus commonly manifesting in addition to dementia with gait impairment and urinary incontinence. If there are such manifestations a lumbar puncture may also be needed for the diagnosis.
The last part describes the changes noted in the white matter and pons. These changes refer to small vessel disease, diffuse changes of the smallest blood vessels. Again these changes are chronic occurring over many years and are commonly found with age. Some changes are again to be found at the age of 78. It is a little difficult to evaluate how advanced these changes are (whether corresponding to her age or too advanced) as the radiologist hasn't given any information regarding their scale (usually there is a severity scale used), not even with simple terms like mild, moderate or severe, so I am afraid it is hard for me to assess that, I can only say that some mild changes are common after the age of 65, so not necessarily worrying. Conditions like high blood pressure increase the chances of such changes to small blood vessels.
So to resume those changes must be cautiously interpreted in correlation with the clinical findings, not alone. They do raise the concern for the possibility of dementia (which may be due to many causes like Alzheimer's, hydrocephalus or also advanced small vessel disease), so evaluation is needed, but only if there are additional clinical manifestations and changes on neuropsychological tests are those MRI changes meaningful, otherwise they might be simply part of aging.
Above answer was peer-reviewed by :
Dr. Yogesh D
Brief Answer:
Evaluation is needed, but no reason for panic.
Detailed Answer:
I read your question carefully and I understand your concern.
First of all I would like to precise that those changes found on the MRI are of a chronic nature. There is no acute lesion, there is no damage sustained from that fall and there isn't any finding indicating an acutely threatening issue requiring immediate intervention.
The first part describes some volume loss. Some volume loss is expected. All of us from our thirties start losing some brain cells and as a result the brain volume is diminished year after year, to a point it is a part of aging. In the first decades these loses aren't noticed on MRIs, but as the years go on as cell loss accumulates it becomes visible. So some degree of volume loss is expected in a patient 78 years old. Usually it's described as mild, moderate or severe. The more pronounced it is, the higher the concern that it is not only due to aging but to dementia (though there isn't an exact correlation, one might have pronounced changes without manifestations of dementia, it aids in the diagnosis but it is the clinical manifesations which matter most). In this case it speaks of moderate changes which certainly do not necessarily indicate dementia and could be normal for her age. It is only if there is proof of impairment of cognitive functions like memory, language, judment etc that a diagnosis of dementia is done. So those neuropsychological tests are more meaningful in that regard than some volume loss.
The next section of the report deals with the fact that these changes are more pronounced in the central part of the brain, making for the appearance of enlarged ventricles (the fluid filled spaces inside the brain). This may be due to neurodegenerative changes like Alzheimers (for which as I said neuropsychological tests are more indicative), but it recalls the attention of the clinician that it may be also due to hydrocephalus, in particular normal pressure hydrocephalus. So the examining neurologist must evaluate whether there are any indications of hydrocephalus commonly manifesting in addition to dementia with gait impairment and urinary incontinence. If there are such manifestations a lumbar puncture may also be needed for the diagnosis.
The last part describes the changes noted in the white matter and pons. These changes refer to small vessel disease, diffuse changes of the smallest blood vessels. Again these changes are chronic occurring over many years and are commonly found with age. Some changes are again to be found at the age of 78. It is a little difficult to evaluate how advanced these changes are (whether corresponding to her age or too advanced) as the radiologist hasn't given any information regarding their scale (usually there is a severity scale used), not even with simple terms like mild, moderate or severe, so I am afraid it is hard for me to assess that, I can only say that some mild changes are common after the age of 65, so not necessarily worrying. Conditions like high blood pressure increase the chances of such changes to small blood vessels.
So to resume those changes must be cautiously interpreted in correlation with the clinical findings, not alone. They do raise the concern for the possibility of dementia (which may be due to many causes like Alzheimer's, hydrocephalus or also advanced small vessel disease), so evaluation is needed, but only if there are additional clinical manifestations and changes on neuropsychological tests are those MRI changes meaningful, otherwise they might be simply part of aging.
Evaluation is needed, but no reason for panic.
Detailed Answer:
I read your question carefully and I understand your concern.
First of all I would like to precise that those changes found on the MRI are of a chronic nature. There is no acute lesion, there is no damage sustained from that fall and there isn't any finding indicating an acutely threatening issue requiring immediate intervention.
The first part describes some volume loss. Some volume loss is expected. All of us from our thirties start losing some brain cells and as a result the brain volume is diminished year after year, to a point it is a part of aging. In the first decades these loses aren't noticed on MRIs, but as the years go on as cell loss accumulates it becomes visible. So some degree of volume loss is expected in a patient 78 years old. Usually it's described as mild, moderate or severe. The more pronounced it is, the higher the concern that it is not only due to aging but to dementia (though there isn't an exact correlation, one might have pronounced changes without manifestations of dementia, it aids in the diagnosis but it is the clinical manifesations which matter most). In this case it speaks of moderate changes which certainly do not necessarily indicate dementia and could be normal for her age. It is only if there is proof of impairment of cognitive functions like memory, language, judment etc that a diagnosis of dementia is done. So those neuropsychological tests are more meaningful in that regard than some volume loss.
The next section of the report deals with the fact that these changes are more pronounced in the central part of the brain, making for the appearance of enlarged ventricles (the fluid filled spaces inside the brain). This may be due to neurodegenerative changes like Alzheimers (for which as I said neuropsychological tests are more indicative), but it recalls the attention of the clinician that it may be also due to hydrocephalus, in particular normal pressure hydrocephalus. So the examining neurologist must evaluate whether there are any indications of hydrocephalus commonly manifesting in addition to dementia with gait impairment and urinary incontinence. If there are such manifestations a lumbar puncture may also be needed for the diagnosis.
The last part describes the changes noted in the white matter and pons. These changes refer to small vessel disease, diffuse changes of the smallest blood vessels. Again these changes are chronic occurring over many years and are commonly found with age. Some changes are again to be found at the age of 78. It is a little difficult to evaluate how advanced these changes are (whether corresponding to her age or too advanced) as the radiologist hasn't given any information regarding their scale (usually there is a severity scale used), not even with simple terms like mild, moderate or severe, so I am afraid it is hard for me to assess that, I can only say that some mild changes are common after the age of 65, so not necessarily worrying. Conditions like high blood pressure increase the chances of such changes to small blood vessels.
So to resume those changes must be cautiously interpreted in correlation with the clinical findings, not alone. They do raise the concern for the possibility of dementia (which may be due to many causes like Alzheimer's, hydrocephalus or also advanced small vessel disease), so evaluation is needed, but only if there are additional clinical manifestations and changes on neuropsychological tests are those MRI changes meaningful, otherwise they might be simply part of aging.
Above answer was peer-reviewed by :
Dr. Yogesh D
Brief Answer:
Looking forward to hearing from you again.
Detailed Answer:
Looking forward to hearing from you again.
Looking forward to hearing from you again.
Detailed Answer:
Looking forward to hearing from you again.
Above answer was peer-reviewed by :
Dr. Raju A.T
Brief Answer:
Looking forward to hearing from you again.
Detailed Answer:
Looking forward to hearing from you again.
Looking forward to hearing from you again.
Detailed Answer:
Looking forward to hearing from you again.
Above answer was peer-reviewed by :
Dr. Raju A.T
Thankyou for answering me. My win sister is on her way to see the neuropyhcologist today, and I will let you know what she has to say. She has to go for a 10 hour evaluation, but not all in one day.
Thankyou for answering me. My win sister is on her way to see the neuropyhcologist today, and I will let you know what she has to say. She has to go for a 10 hour evaluation, but not all in one day.
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