What Does Centrum Semiovale Hyperintensities On MRI Indicate?

Brief Answer:
Hyperintensities in the centrum semiovale

Detailed Answer:
Good afternoon. My name is Dr. Saghafi and I am a neurologist from XXXXXXX OH. I'd like to comment on your statement above. Unfortunately, you did not provide any demographic information on your gender, age, or medications that you may have been prescribed. In cases such as these it is often helpful to have such information since certain disease entities can be considered more or less legitimately if we knew the demographic information of the patient.

Be that as it may the presence of high intensity lesions ANYWHERE in the brain of the type you describe usually represents a form of DEMYELINATION. This refers to the loss of a protein insulator called MYELIN that encases all nerve dendrites and axons in order to facilitate electrical transmission. By losing the myelin covering a nerve will lose the ability to send information downstream and this can result in malfunctions. These malfunctions can be in terms of motor commands (i.e. orders to move a limb or other part of the body). They could be transmissions having to do with the processing of or assimilation of sensory information (i.e. being able to properly identify certain sensations such as hot, cold, sharp, dull).

Demyelination of nerves can occur for a variety of reasons such as metabolic, infectious, drug induced, traumatic degeneration, hypertension, hypercholesterolemia, diabetes mellitus, history of smoking or being exposed to second hand smoke, autoimmune processes, etc. Whenever the location of this demyelination or "high signal intensity" is stated to be in the centrum semiovale and it is in both hemispheres as stated in the report then, the most likely causes seem to be involving things such as smoking history, hypertension, high cholesterol, and diabetic complications. Other things can also be considered especially if lesions are particularly big....In other words, if most of the lesions are more along the 2 mm. diameter then, those are relatively small....but if they are more on the 5mm. or larger level then, those are a bit bigger and deserve some more analysis.

I don't see where hyperreflexia fits into the imaging findings since you are saying it is much worse on the right side yet the imaging report really doesn't suggest a difference in distribution or density of lesions between one side and another...I read it as being equally or similarly distributed between the 2 sides.

However, again, a closer look at symptoms, history of evolution, and other physical and laboratory findings would be helpful in your case to make a better call.

If you have the actual full radiology report and you'd like to post it for review that might be helpful.

I'd appreciate the favor of your providing a STAR RATING and some brief written feedback if your questions have been satisfactorily answered. In addition, CLOSING THE QUERY on your end will also be most helpful as well as help other doctors use the information I've provided in this case for other patients with similar pictures.

Don't forget that my webpage to keep me abreast as to how you're doing is:

bit.ly/drdariushsaghafi

All the Best

This query has required a total of 35 minutes of physician specific time to read, research, and compile the return to the patient.

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