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Suggest Treatment For Tremors And Vertigo
Question: I'm 49 to female with hx of tremors balance disorder, some nystagmus,vertigo but mostly NOT associated with dizziness. More like disembarkmentioned feeling and 30 + year history of migraines that seem to be worsening. Multiple mri..new finding on mri is top normal prominence of the sulc extrai axial spaces bifrontally. What does this mean.
Expressive aphasia, difficulty paying attention, visual disturbances, hearing decrease, romantic decreased by 10 degrees in all directions, visual field decreased, motor function 4/5, trandom not possible, also heelwalking toe walking or he'll-toe line not feasible. multiple falls-one resulting in r shoulder surgery, ,one resulting in fx l wrist, nl emg,ncv, previous eeg with some sharp spikes, recent eeg unavailable. Occ problems with memory. +1,q2 cataracts, wt103, up from 92lbs. Ht 65in.
Expressive aphasia, difficulty paying attention, visual disturbances, hearing decrease, romantic decreased by 10 degrees in all directions, visual field decreased, motor function 4/5, trandom not possible, also heelwalking toe walking or he'll-toe line not feasible. multiple falls-one resulting in r shoulder surgery, ,one resulting in fx l wrist, nl emg,ncv, previous eeg with some sharp spikes, recent eeg unavailable. Occ problems with memory. +1,q2 cataracts, wt103, up from 92lbs. Ht 65in.
Brief Answer:
Meaning of MRI not clinically significant to any extent
Detailed Answer:
Good evening. I am an Adult Neurologist and Headache Specialist in the XXXXXXX OH area of the world. I'd like to answer your question on the meaning of the MRI you obtained.
I've read your history and am sorry you're feeling the way you are with tremors, balance disorder, nystagmus, vertigo WITHOUT DIZZINESS (not sure I comprehend what is meant WITHOUT dizziness).
Your MRI talks about PROMINENCE of the sulci and extra axial spaces bifrontally.
Unfortunately, your MRI picture can be normal. A better question to consider would be how this the LATEST MRI compare with either the very first one you ever got or the very last one you got? That would be worth comparing in your case.
The report is calling for widened GROOVES in the brain (sulci) which are essentially the folds of the brain or the VALLEYS that are found between the partitions of brain tissue. When we say that the SULCI are widened we usually mean to suggest that there could be some brain shrinkage going on in that brain. Bifrontally simply means that what they're seeing those widened spaces in BOTH FRONTAL AREAS of the brain.
The extraaxial spaces refer all the spaces in the skull overlying or even underlying the brain itself. In other words, how much OPEN SPACE surrounding or outside the brain is there? That is EXTRA-AXIAL. It would appear that the MRI in your case is showing at least a moderate amount of extra-axial space prominence. Is it clinically relevant? It's hard to say unless we have previous MRI's to look at and compared.
If you can upload your MRI images and the reports to this website, I'd be happy to look at your case in more detail.
You may have a condition known as NPH or NORMAL PRESSURE HYDROCEPHALUS. I would recommend an evaluation of your condition with complete history and physical by a neurologist who may wish to consider a consultation with a neurosurgeon for the purpose of placing a shunt in the brain to drain what may be excess fluid from the brain down into the stomach or intestines.
NPH can result in virtually each and every symptom you've been describing including electrical aberrations and memory problems. You should consider getting a consultation with a neurologist who may go back and find out from the radiologist whether or not you may have what's called "subependymal sweeling" which a hallmark of NPH. Also, the neurologist will either want to drain spinal fluid himself or they'll send you on for another consult right away with a neurosurgeon to get their opinion on things.
If this answer satisfactorily addresses your question then, I'd appreciate the favor of a HIGH STAR RATING with some written feedback on your part.
Also, CLOSING THE QUERY on your end (if there are no further comments) will be most helpful and appreciated so that this question can be transacted and archived expeditiously for further reference by colleagues as necessary.
Please keep me informed as to the outcome of your situation by writing me at: bit.ly/drdariushsaghafi
All the best
The query has required a total of 24 minutes of physician specific time to read, research, and compile a return envoy to the patient.
Meaning of MRI not clinically significant to any extent
Detailed Answer:
Good evening. I am an Adult Neurologist and Headache Specialist in the XXXXXXX OH area of the world. I'd like to answer your question on the meaning of the MRI you obtained.
I've read your history and am sorry you're feeling the way you are with tremors, balance disorder, nystagmus, vertigo WITHOUT DIZZINESS (not sure I comprehend what is meant WITHOUT dizziness).
Your MRI talks about PROMINENCE of the sulci and extra axial spaces bifrontally.
Unfortunately, your MRI picture can be normal. A better question to consider would be how this the LATEST MRI compare with either the very first one you ever got or the very last one you got? That would be worth comparing in your case.
The report is calling for widened GROOVES in the brain (sulci) which are essentially the folds of the brain or the VALLEYS that are found between the partitions of brain tissue. When we say that the SULCI are widened we usually mean to suggest that there could be some brain shrinkage going on in that brain. Bifrontally simply means that what they're seeing those widened spaces in BOTH FRONTAL AREAS of the brain.
The extraaxial spaces refer all the spaces in the skull overlying or even underlying the brain itself. In other words, how much OPEN SPACE surrounding or outside the brain is there? That is EXTRA-AXIAL. It would appear that the MRI in your case is showing at least a moderate amount of extra-axial space prominence. Is it clinically relevant? It's hard to say unless we have previous MRI's to look at and compared.
If you can upload your MRI images and the reports to this website, I'd be happy to look at your case in more detail.
You may have a condition known as NPH or NORMAL PRESSURE HYDROCEPHALUS. I would recommend an evaluation of your condition with complete history and physical by a neurologist who may wish to consider a consultation with a neurosurgeon for the purpose of placing a shunt in the brain to drain what may be excess fluid from the brain down into the stomach or intestines.
NPH can result in virtually each and every symptom you've been describing including electrical aberrations and memory problems. You should consider getting a consultation with a neurologist who may go back and find out from the radiologist whether or not you may have what's called "subependymal sweeling" which a hallmark of NPH. Also, the neurologist will either want to drain spinal fluid himself or they'll send you on for another consult right away with a neurosurgeon to get their opinion on things.
If this answer satisfactorily addresses your question then, I'd appreciate the favor of a HIGH STAR RATING with some written feedback on your part.
Also, CLOSING THE QUERY on your end (if there are no further comments) will be most helpful and appreciated so that this question can be transacted and archived expeditiously for further reference by colleagues as necessary.
Please keep me informed as to the outcome of your situation by writing me at: bit.ly/drdariushsaghafi
All the best
The query has required a total of 24 minutes of physician specific time to read, research, and compile a return envoy to the patient.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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