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What Does My Brain MRI Scan Test Report Indicate?

Posted on Tue, 15 Dec 2015

Question: My son was seen by a neurologist for toe walking, hypertonic muscles and a babinski reflex. We had a brain mri and lumbar spine done. The first neurologist said that the ADC images show increased signal around the occipital horns or the lateral ventricles bilaterally. He said the the spine looked ok. We had a second opinion at a Childrens Hospital and they said that the spine showed that the filum looked fatty it may have the same significance as a tethered cord. ie not allowing the cord to expand as it should with age. She did mention that the MRI had some motion artifact. What does this all mean and should we get another MRI? We already had to sedate him once for the MRI. The two doctors seem to see things differently which worries me

Answered by Dr. Ajay Panwar (59 minutes later)

Brief Answer:
Please upload MRI image/CD.Let me read it.

Detailed Answer:
Hi XXXX,
Thanks for being on healthcaremagic.com.
I am Dr.Ajay Panwar,a neurologist,here to answer your query.

I understand your worries and shall try to address them with my best concerns.For the same I need-
1)Your son's MRI. Please upload the images or CD(preferable) on google drive and share the link here in the follow-up question.I shall read your MRI to make an impression.
2)Your son's case summary/neurological examination documents.Please upload them here as scanned images.You mentioned he had hypertonia and babinski positive.There must be some other important examination findings as well.

3)Tell details about symptoms-
a)What are the symptoms?
b)Since when he is having them?
c)Was he normal at birth and did he attain normal milestones?
In nutshell,I want to know the case history.

I shall be looking towards your follow-up query with the above details.

Regards
Dr.Ajay Panwar,
MD,DM(Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ajay Panwar (3 days later)

I could not figure out a way to get the disc to you. We had a third neuro rad doctor review it and agrees that there is a fatty fileum terminate but a normal clonus for his age. What is protocol for a child with toe walking, hypertonic muscles, babinski reflex and the fatty fileum? Is surgery recommended?

Answered by Dr. Ajay Panwar (17 minutes later)

Brief Answer:
Surgery can be done.

Detailed Answer:
Hi XXXX,
Thanks for being in follow-up.

Fatty filum can result in Tethered cord symptoms. Tethered cord syndrome can result in toe walking,brisk reflexes and babinski reflex. Because the symptoms are marked,it deserves a surgical intervention.
This,though, is in keeping with the opinion that there is no significant pathology in brain.
How are his bladder functions?Any urination problems?

Regards
Dr.Ajay Panwar,
MD,DM(Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ajay Panwar (9 minutes later)

He is not toilet trained yet so I am not sure about bladder issues. He has never had a bladder infection to date.

Answered by Dr. Ajay Panwar (23 minutes later)

Brief Answer:
Please consult a spine surgeon.

Detailed Answer:
Hi XXXX,
Thanks for being in follow-up.

Anyways, with these much neurological deficits, this deserves a surgical intervention.I suggest you to please consult a spine surgeon for the same.

If you have any further questions,I shall be glad to have you in follow-up,else if you liked the answer,please rate it and write a review.

Regards
Dr.Ajay Panwar,
MD,DM(Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar