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What Does My MRI Scan Test Report Indicate?
Question: Just received MRI results... can you please interpret?
MRI Brain WO contract:
7 mm focus of T2 shortening in the left temporal stem, series 7, image 10. Lesion demonstrates blooming on the SWAN sequence, series 6, image 55. On the PD and FLAIR sequence, there is a suggestion of central T2 hyperintensity. No surrounding edema. Impression: Small hemorrhagic lesion in the left temporal stem with imaging characterless most compatible with cavernous malformation. Consider follow up MRI in 3-6 months, including high-resolution T2 and postcontrast imaging through this region.
C2-C3: unremarkable. C3-C4: Trace disc bulge. No canal or foraminal narrowing. C4-C5: trace disc bulge. spinal canal remains widely patent. Mild bilateral foraminal narrowing from uncinate hypertrophy. C5-C6: Trace disc bulge. Spinal canal remains widely patent. No foraminal narrowing. C6-C7: small central disc protrusion. Spinal canal remains widely patent. No foraminal narrowing. C7-T1: within normal limits. Impression: Very mild multilevel degenerative change detailed above. No significant canal or foraminal narrowing at any level.
MRI Brain WO contract:
7 mm focus of T2 shortening in the left temporal stem, series 7, image 10. Lesion demonstrates blooming on the SWAN sequence, series 6, image 55. On the PD and FLAIR sequence, there is a suggestion of central T2 hyperintensity. No surrounding edema. Impression: Small hemorrhagic lesion in the left temporal stem with imaging characterless most compatible with cavernous malformation. Consider follow up MRI in 3-6 months, including high-resolution T2 and postcontrast imaging through this region.
C2-C3: unremarkable. C3-C4: Trace disc bulge. No canal or foraminal narrowing. C4-C5: trace disc bulge. spinal canal remains widely patent. Mild bilateral foraminal narrowing from uncinate hypertrophy. C5-C6: Trace disc bulge. Spinal canal remains widely patent. No foraminal narrowing. C6-C7: small central disc protrusion. Spinal canal remains widely patent. No foraminal narrowing. C7-T1: within normal limits. Impression: Very mild multilevel degenerative change detailed above. No significant canal or foraminal narrowing at any level.
Brief Answer:
A blood vessel malformation.
Detailed Answer:
I read your question carefully and I understand your concern.
Now the MRI includes two parts, the brain and the spine exam. Regarding the second part, the spinal one there is no reason for concern, there are some changes of the spine during the wear and tear on it over the years, but mild ones, can find them in no people, do not need any medication or procedure, if suffering from neck pain physical therapy may be considered to strengthen your muscles and prevent further changes.
On the brain part there is a cavernous malformation, a blood vessel abnormality. It is a common one. Often it is asymptomatic and may live with it a long healthy life. The risk it presents is that of bleeding. The risk of a bleed is small (less than 1%) for that reason when they have not bled they are often left as they are and simply followed with control MRI like that report recommends. If they cause a hemorrhage once then it may be decided to intervene through surgery or in some locations which can not be reached by surgery through radiation, as the risk of rebleeding is higher (varies among studies from 4 to 25% a year).
At times may be decided to intervene when it causes some other symptom such as inciting epileptic seizures.
So in your case if you have no seizures it will probable be opted for the waiting approach, checking it periodically with MRI. However every case is a history apart, it should be discussed with your doctors, taking into consideration the location, accessibility and risks for surgery and symptoms. It represents no emergency naturally since as I said carries a very low risk.
I remain at your disposal for other questions.
A blood vessel malformation.
Detailed Answer:
I read your question carefully and I understand your concern.
Now the MRI includes two parts, the brain and the spine exam. Regarding the second part, the spinal one there is no reason for concern, there are some changes of the spine during the wear and tear on it over the years, but mild ones, can find them in no people, do not need any medication or procedure, if suffering from neck pain physical therapy may be considered to strengthen your muscles and prevent further changes.
On the brain part there is a cavernous malformation, a blood vessel abnormality. It is a common one. Often it is asymptomatic and may live with it a long healthy life. The risk it presents is that of bleeding. The risk of a bleed is small (less than 1%) for that reason when they have not bled they are often left as they are and simply followed with control MRI like that report recommends. If they cause a hemorrhage once then it may be decided to intervene through surgery or in some locations which can not be reached by surgery through radiation, as the risk of rebleeding is higher (varies among studies from 4 to 25% a year).
At times may be decided to intervene when it causes some other symptom such as inciting epileptic seizures.
So in your case if you have no seizures it will probable be opted for the waiting approach, checking it periodically with MRI. However every case is a history apart, it should be discussed with your doctors, taking into consideration the location, accessibility and risks for surgery and symptoms. It represents no emergency naturally since as I said carries a very low risk.
I remain at your disposal for other questions.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you so much for answering the question.
When I went to see my neurologist for frozen shoulder (it's been 7 years) he taped my shoulder blades together which resulted in intense pain 5 days later in the lower part of my skull. I couldn't move my neck and the pain would radiate up my skull. It didn't feel like a headache as it was more on the surface and felt like it was coming from the neck.
The symptoms I've been experiencing that are ongoing are: swelled white tongue, soreness in throat, hair loss, dizziness, and pain in my lower skull radiating into my head. The more my tongue burns, the more my scalp hurts, the more hair loss I have. The first symptom I experience is in my throat, which then moves up into my mouth. My neurologist seems to think this is due to the occipital nerve.. does anything on my MRI show that the occipital nerve could be damaged or pinched? Is that possible? Could the lesion be causing these problems? I've also experienced numbness down my right arm and down my left leg. The hospital doctor was concerned with multiple sclerosis... could the lesion cause any of this? Also, after experiencing pain in my lower skull after my back was taped, the area of my left eye swelled. It was near my temple and under eye. What do you think could cause this? Would the lesion be responsible for this?
Thank you so much!!!
XXXX
Also, did my lesion cause any hemorrhage or can you not tell from the report?
When I went to see my neurologist for frozen shoulder (it's been 7 years) he taped my shoulder blades together which resulted in intense pain 5 days later in the lower part of my skull. I couldn't move my neck and the pain would radiate up my skull. It didn't feel like a headache as it was more on the surface and felt like it was coming from the neck.
The symptoms I've been experiencing that are ongoing are: swelled white tongue, soreness in throat, hair loss, dizziness, and pain in my lower skull radiating into my head. The more my tongue burns, the more my scalp hurts, the more hair loss I have. The first symptom I experience is in my throat, which then moves up into my mouth. My neurologist seems to think this is due to the occipital nerve.. does anything on my MRI show that the occipital nerve could be damaged or pinched? Is that possible? Could the lesion be causing these problems? I've also experienced numbness down my right arm and down my left leg. The hospital doctor was concerned with multiple sclerosis... could the lesion cause any of this? Also, after experiencing pain in my lower skull after my back was taped, the area of my left eye swelled. It was near my temple and under eye. What do you think could cause this? Would the lesion be responsible for this?
Thank you so much!!!
XXXX
Also, did my lesion cause any hemorrhage or can you not tell from the report?
Brief Answer:
Lesion not the cause
Detailed Answer:
Regarding those symptoms you describe I can assure you that lesion is not responsible for those at all, at that small size it shouldn't cause any headache or other symptom, the only possible one would be seizure. It is in my opinion a coincidental finding, as I said it is a common malformation. The headache as you describe is caused by neck issues with muscle spasms, such neck pain often irradiates in the neck. Occipital neuralgia is a common diagnosis, so it was a valid possibility, but the upper vertebrae of the neck whose changes lead to occipital neuralgia do not show much change, so MRI doesn't support that diagnosis. The multiple sclerosis is excluded by the MRI as well.
As for whether it has bled, the MRI doesn't show any recent bleeding, it shows signs of old hemorrhage inside the malformation which is expected, as the thin abnormal vessels at the center of the malformation have a tendency of rupturing and causing small hemorrhages in the inside of it. Not symptomatic bleed which need intervention though.
I hope to have been of help.
Lesion not the cause
Detailed Answer:
Regarding those symptoms you describe I can assure you that lesion is not responsible for those at all, at that small size it shouldn't cause any headache or other symptom, the only possible one would be seizure. It is in my opinion a coincidental finding, as I said it is a common malformation. The headache as you describe is caused by neck issues with muscle spasms, such neck pain often irradiates in the neck. Occipital neuralgia is a common diagnosis, so it was a valid possibility, but the upper vertebrae of the neck whose changes lead to occipital neuralgia do not show much change, so MRI doesn't support that diagnosis. The multiple sclerosis is excluded by the MRI as well.
As for whether it has bled, the MRI doesn't show any recent bleeding, it shows signs of old hemorrhage inside the malformation which is expected, as the thin abnormal vessels at the center of the malformation have a tendency of rupturing and causing small hemorrhages in the inside of it. Not symptomatic bleed which need intervention though.
I hope to have been of help.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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