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What Do The Following MRI Reports Indicate?

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Posted on Wed, 25 Jan 2017
Question: I have two MRI's taken 7 months apart showing T2 signal abnormality with minimal periventricular white matter disease, and a year later a cervical MRI showing increased signal intensity cervical cord T2 weighted sagittal images. Also with the Cervical MRI's there is flow artifact of the Ventral Thecal Sac, C5-6 also with mild to moderate bilateral foramina narrowing, and mild effacement of the thecae sac and cord. At C6-7 there is mild right foramina narrowing and moderate left foramine narrowing, mild effacement of the ventral thecae sac and cord, canal narrowing not excluded, and at C7-T1 limited demonstration canal, mild effacement of the thecae sac and cord.These images are 2 years ago and over the last year, I have had severe neurological deficits. I cannot walk on my own, and only 15 feet with help, Therefore, I am wheelchair bound.I have decreased sensations and weakness in my legs and arms, particularly on my right side. I have lumbar adhesive arachnoiditis, severe body pain, and numbness in my hands and legs. It hurts like a sunburn to put my clothes on. I have pain from my shoulder down my right arm, and numbness and temporary morning paralysis of my hand. I have a difficult time finding words, or keeping a thought. I have become a lot slower in my thought process, and have overall difficulties maintaining a normal neurological function. I have also had a drastic change in my eyesight and glasses prescription last summer. I used to have a 132 IQ, and have a Masters degree, but I feel like I'm getting dumber as time goes on, and I can't remember too many things. What does all this mean?
doctor
Answered by Dr. Dr. Erion Spaho (57 minutes later)
Brief Answer:
Consider multiple sclerosis.

Detailed Answer:
Hello and thanks for using HCM.

I have read your question and understand your concerns.

In my opinion, a part of symptoms you describe ( numbness, tingling, body pain, difficulty walking, etc.) are caused by spinal cord compression at cervical level and adhesive arachnoiditis at lumbar level.

In the other hand, cognitive and vision issues may be caused by demyelinating disease such multiple sclerosis, since there are found periventricular white matter changes on MRI.

Increase in signal intensity of the cervical spine also may be a multiple sclerosis plaque.

Multiple sclerosis also may cause tingling and numbness in different parts of the body.

So, I think you should discuss with your Neurologist about considering and getting evaluated further about multiple sclerosis.

Treating both these conditions (multiple sclerosis and spinal stenosis, arachnoiditis) should improve at least partially your overall condition.

Hope you found the answer helpful.

Let me know if I can assist you further.

Greetings.

Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Dr. Erion Spaho (32 minutes later)
I have asked my neurologist to look into MS, and she doesn't think it is that, although she wants to do a lumbar puncture. However, I have a spinal stimulator and leads in my lumbar region. I am chronically deficient in Vitamin D, and have been on high levels off and on for many years. My Vitamin D level is only 18. She also told me that my B12 level was borderline low, but according to the values, it is not. My Vitamin B12 level is 391 and the range is 200 to 1100, so this isn't the problem.She also checked my folate levels and my thyroid. My thyroid is 1.56, right in the middle of the range, and my folate is >24.0 which the normal level is >5.4. I have worked with someone who used to work with the MS society in town, and even she thought it was MS. How do I get the neurologist to take me seriously?

My apologies, in addition to the original report, the impression that they wrote was
"Minimal T2 signal abnormality identified. I suspect this is sequela of chronic small vessel ischemic change. Linear abnormality seen extending from the atria the right lateral ventricle raising the possibility of demyelination in the appropriate clinical setting." What exactly does this mean, broken down?
doctor
Answered by Dr. Dr. Erion Spaho (12 hours later)
Brief Answer:
Doubts about MS exist clinically and by imaging studies.

Detailed Answer:
Welcome back.

Broken down, it means that doubts about multiple sclerosis or other conditions that may cause myelin damage are present in the MRI report.

Clinical setting exists, so, since there is doubt about demyelination, further evaluation is necessary.

In my opinion, a new MRI of brain and cervical spinal cord is necessary to evaluate the progression or not of the abnormalities found before in MRI.

If still in doubt after the new MRI, lumbar puncture is necessary.

Hope this helps.

Kind regards.


Above answer was peer-reviewed by : Dr. Remy Koshy
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Answered by
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Dr. Dr. Erion Spaho

Neurologist, Surgical

Practicing since :2004

Answered : 4502 Questions

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What Do The Following MRI Reports Indicate?

Brief Answer: Consider multiple sclerosis. Detailed Answer: Hello and thanks for using HCM. I have read your question and understand your concerns. In my opinion, a part of symptoms you describe ( numbness, tingling, body pain, difficulty walking, etc.) are caused by spinal cord compression at cervical level and adhesive arachnoiditis at lumbar level. In the other hand, cognitive and vision issues may be caused by demyelinating disease such multiple sclerosis, since there are found periventricular white matter changes on MRI. Increase in signal intensity of the cervical spine also may be a multiple sclerosis plaque. Multiple sclerosis also may cause tingling and numbness in different parts of the body. So, I think you should discuss with your Neurologist about considering and getting evaluated further about multiple sclerosis. Treating both these conditions (multiple sclerosis and spinal stenosis, arachnoiditis) should improve at least partially your overall condition. Hope you found the answer helpful. Let me know if I can assist you further. Greetings.