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What Do The Following CT And MRI Scan Reports Indicate?
Question: Hello,
My husband recent CT and MRI result show no acute intracranial hemorrhage with mild generalized cerebral volume loss. Would you please explain how serious is it? And what is that exactly mean? Last several months he is getting worse. he does not understand what is happens around him and does not remember anything.
He has current diagnosis:
Anoxic brain injury
Dementia
Acute encephalopathy
Seizure disorder
Aphasia
Cognitive impairment
Psychiatric disorder
Gait disturbance
Generalized weakness
Diabetes, hypertention
Neurologist discontinued of Donepezil , considering this is not the case of Alzheimer dementia, but his cognitive impairment is rather anoxic brain injury due to suicide attempt. So it is mean that XXXXXXX has an organic brain injury?
and this medication does not help him at all because there is no improvements for the last year and a half.
My husband recent CT and MRI result show no acute intracranial hemorrhage with mild generalized cerebral volume loss. Would you please explain how serious is it? And what is that exactly mean? Last several months he is getting worse. he does not understand what is happens around him and does not remember anything.
He has current diagnosis:
Anoxic brain injury
Dementia
Acute encephalopathy
Seizure disorder
Aphasia
Cognitive impairment
Psychiatric disorder
Gait disturbance
Generalized weakness
Diabetes, hypertention
Neurologist discontinued of Donepezil , considering this is not the case of Alzheimer dementia, but his cognitive impairment is rather anoxic brain injury due to suicide attempt. So it is mean that XXXXXXX has an organic brain injury?
and this medication does not help him at all because there is no improvements for the last year and a half.
Brief Answer:
Read below.
Detailed Answer:
I read your question carefully and I understand your concern.
That MRI in itself doesn't show anything serious, it doesn't show any acute damage. There is mild generalized volume loss which has to be interpreted according to the age. Each of us starts to lose some brain cells after our thirties and as the years go by this loss starts to become evident on MRI. So with age that is a common finding and to a point a mild loss could be just part of aging if the person doesn't show any symptom, saying simply mild loss is a subjective term as there are no precise reference values.
However when there is a diagnosis of dementia then the two things may be related. That volume loss may be an indication that there is widespread damage due to that anoxic injury. It may not have caused a visible damage to a precise area like in say stroke or tumor, but has damage a number of cells in a diffuse manner. MRI can not detect such loss at a cellular level, so from a practical point of view it doesn't make the diagnosis but simply excludes issues like tumor, stroke, inflammation etc and also is an argument against Alzheimer where volume loss dominates in the temporal lobes.
Perhaps an MRI at the time of the anoxic injury may have shown the damage better if you have any report from that time?
So I would agree with the neurologist that the dementia in this case is unlikely to be Alzheimer. Being due to the brain injury which has already taken place I am afraid that there is not any medication to reverse what has happened, some improvement is hoped in the first 6 months after the injury but it is not a question of drugs as much as the brain compensating for the lost cells.
One issue which strikes me though and which may be worked upon is the medication. Looking at the list he is taking many drugs acting on the central nervous system, the first 6 of them are all such drugs. These drugs may have side effects including on cognitive functions. I am not saying that his issues are all due to the drugs but certainly they do not help with the cognitive area. So I think you should discuss the issue of poly-pharmacy with your doctor, whether there is the possibility to reduce the number of drugs he is taking.
I remain at your disposal for other questions.
Read below.
Detailed Answer:
I read your question carefully and I understand your concern.
That MRI in itself doesn't show anything serious, it doesn't show any acute damage. There is mild generalized volume loss which has to be interpreted according to the age. Each of us starts to lose some brain cells after our thirties and as the years go by this loss starts to become evident on MRI. So with age that is a common finding and to a point a mild loss could be just part of aging if the person doesn't show any symptom, saying simply mild loss is a subjective term as there are no precise reference values.
However when there is a diagnosis of dementia then the two things may be related. That volume loss may be an indication that there is widespread damage due to that anoxic injury. It may not have caused a visible damage to a precise area like in say stroke or tumor, but has damage a number of cells in a diffuse manner. MRI can not detect such loss at a cellular level, so from a practical point of view it doesn't make the diagnosis but simply excludes issues like tumor, stroke, inflammation etc and also is an argument against Alzheimer where volume loss dominates in the temporal lobes.
Perhaps an MRI at the time of the anoxic injury may have shown the damage better if you have any report from that time?
So I would agree with the neurologist that the dementia in this case is unlikely to be Alzheimer. Being due to the brain injury which has already taken place I am afraid that there is not any medication to reverse what has happened, some improvement is hoped in the first 6 months after the injury but it is not a question of drugs as much as the brain compensating for the lost cells.
One issue which strikes me though and which may be worked upon is the medication. Looking at the list he is taking many drugs acting on the central nervous system, the first 6 of them are all such drugs. These drugs may have side effects including on cognitive functions. I am not saying that his issues are all due to the drugs but certainly they do not help with the cognitive area. So I think you should discuss the issue of poly-pharmacy with your doctor, whether there is the possibility to reduce the number of drugs he is taking.
I remain at your disposal for other questions.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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