MRI Showed Scattered T2 Hyperintensities In White Matter. What Does It Mean?

Posted on Sun, 24 Jun 2012

Question: I am 51, 5ft 1 in tall, 108 lbs. I was in an auto accident 4.5 years ago and have sustained many injuries.
I just had an MRI of the brain and I was wondering what Scattered T2 hyperintensities in the supratorial white matter that may be related to some small vessel ischemic changes, and inflammatory etiology cannot be excluded means.

Answered by Dr. Shivakumar S. Kupanur (1 hour later)

Hello.

Thanks for posting your query.

Hyperintensity on T2 sequence indicates the characteristic brain tissue in that particular area of brain (in your case supratentorail white matter) is different from the rest of the brain. It looks bright on MRI.

These hyperintensities are non-specific and does not carry any diagnostic significance, if the patient is asymptomatic. It needs clinical co-relation for exact interpretation.

These hyperintensities could be due:
1. Small vessel ischemic changes, where the blood suppy to that particular area of brain is compromised to some extent.
2. Inflammation of arteries in the brain, vasculitis.
3. Multiple sclerosis, etc.

It is difficult to come to conclusion whether it is due to ischemic changes or inflammatory cause based on MRI. It needs further evaluation like MR Sprctroscopy for iscmemic changes and biopsy to rule out inflammatory cause.

If you do not have any symptoms like seizures, limb weakness or any neurological deficits, there is no need to worry about these findings and further investigations can be deferred safely in that scenario. In case, if you have any, you can consult your Neurologist for further management.

I hope, I have answered your query. Please accept my answer in case you have no follow up queries.

Regards.

Above answer was peer-reviewed by : Dr. Jyoti Patil

Follow up: Dr. Shivakumar S. Kupanur (42 minutes later)

What would be neurological deficits be? I have limb weakness but I have a bone pressing on my spinal cord in my neck and pinched nerves in my low spine, so how would I know which is the cause.

Answered by Dr. Shivakumar S. Kupanur (8 hours later)

Hello,

Thanks for writing back.

There is wide spectrum of Neurological deficits which includes:
- Weakness / paralysis of a limb or the entire body.
- Impaired hearing or vision.
- Loss / Disturbance of sensation.
- Impairment or loss of speech.
- Tremor, or other movement disorders.
- Gait problems.

Occurrence of these deficits depends on the level of disease or area involved.

Your limb weakness could be due to isolated cervical and lumbar disc degeneration. A good neurological examination by Neurologist with MRI spine will help us to differentiate the cause.

I hope this clarifies your doubts. Please accept my answer in case you have no follow up queries.

Wish you good health.

Regards

Above answer was peer-reviewed by : Dr. Prasad