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What Does My Niece's MRI Report Suggest?

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Posted on Mon, 29 Sep 2014
Question: I took my niece for MRI. The doctor concluded That their is b/l symmetrical pareital lobe and peritrigonal white matter hyperintensity...i am really worried about her...wat is the treatment for this.she is only 10 years old
doctor
Answered by Dr. Diptanshu Das (19 minutes later)
Brief Answer:
Multiple sclerosis or perinatal asphyxia

Detailed Answer:
Thanks for posting your query at HealthCareMagic. You have not indicated the reason for your taking your niece to the doctor. The complaints she had, are important. Furthermore, I need to know from when the complaints are present. I also need to know whether she has any perinatal asphyxia and whether she is presently suffering from spastic diplegia, a form of cerebral palsy. If she was normal from birth but has subsequently been developing symptoms, it could also be multiple sclerosis.

With the little information that I have available from your query, let me mention that in case of a newborn, the brain development is incomplete. If the newborn suffers from lack of oxygen, a portion of brain may get damaged as the brain does not have any oxygen store. Myelination is a dynamic process that occurs during foetal life and goes on after birth in a well-defined, predetermined manner. The process is analogous to insulation of nerve fibres and is required for their proper functioning. On T1-weighted images, the pattern of myelination reaches the adult aspect at 1 year of age; on T2-weighted images, at about 2 years of age. On MR images, the last associative area to mature is considered to be the peritrigonal zone-a triangular region posterior and superior to the trigones of the lateral ventricles characterized by a persistent high signal intensity on T2-weighted images as you have mentioned. It indicates that the damage has already occurred and rather there is a lack in development. Going through the following article might be helpful: http://www.ijri.org/article.asp?issn=0971-3026;year=2002;volume=12;issue=1;spage=43;epage=50;aulast=Lakhkar

Developmental support and symptomatic relief can help the child to get over her disabilities. Unless I can know the exact nature of complaints, it is hard for me to comment.
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Diptanshu Das (57 minutes later)
she is been complaining of acute pain for last 45 days. When we divert her mind she doesnt remember about pain. Sometimes she complain about vomitting. she was a premature baby.
doctor
Answered by Dr. Diptanshu Das (10 minutes later)
Brief Answer:
Adequate details required

Detailed Answer:
Thanks for writing back but the details are inadequate. I understand that she was born preterm, which is a predisposing factor. But I need to know if she cried at birth and whether she suffered from any perinatal asphyxia accordingly. Secondly, I need to know the exact nature of problems when they started along with the timeline. The next thing would be whether the developmental milestones were proper or delayed and whether she has or had any disabilities like cerebral palsy or increased body tone. I would like to enquire about her intelligence and memory. The last thing to ask for would be that whether she was otherwise well 45 days back and where exactly is the location of the pain that you are talking about. Please revert back with the above information and I would be happy to help.
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Diptanshu Das (59 minutes later)
sir she was suffering from lack of oxygen after birth and was kept in a box. she had fits problem 4-5 years ago. once her ada level in body was more than 2. She was treated with antibiotics. she always suffer from cold,cough. she used to complain of acute headaches sometimes after having coffee. She is not having any disablities. The pain is mostly on the front part of the brain. She was very well 45 days back and was feeling cold sometimes. she is very intelligent and have sharp memory. shes having some extra hairs under arms. sir pls suggest any treatment. is the dsiorder serious??sir pls suggest
doctor
Answered by Dr. Diptanshu Das (38 minutes later)
Brief Answer:
Plasticity of brain has overcom perinatal asphyxia

Detailed Answer:
Thanks for writing in detail. At birth, when she suffered from lack of oxygen, portions of her brain were unable to survive. Since the infant brain has good amount of plasticity, the repair work and the reallocation of function to other active parts of the brain has been really good, the reason for which she is able to do without disabilities. But let me mention, that there are portions of the brain that are still inactive and non-functional and the MRI shows those changes. Rather than being bothered about them, I would say that be in touch with a centre that deals with developmental pediatrics and they would be able to stimulate her properly in order to help her to reach her potentials. Do not bother about the extra hair under the arms. Her hormonal profile needs to be done to be able to comment on that but that is entirely a different issue.

Hope that I have been able to clarify your queries. If you appreciate my answer, please leave a 5 star rating for the answer and also a review.
Above answer was peer-reviewed by : Dr. Yogesh D
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Answered by
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Dr. Diptanshu Das

Pediatrician

Practicing since :2005

Answered : 3877 Questions

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What Does My Niece's MRI Report Suggest?

Brief Answer: Multiple sclerosis or perinatal asphyxia Detailed Answer: Thanks for posting your query at HealthCareMagic. You have not indicated the reason for your taking your niece to the doctor. The complaints she had, are important. Furthermore, I need to know from when the complaints are present. I also need to know whether she has any perinatal asphyxia and whether she is presently suffering from spastic diplegia, a form of cerebral palsy. If she was normal from birth but has subsequently been developing symptoms, it could also be multiple sclerosis. With the little information that I have available from your query, let me mention that in case of a newborn, the brain development is incomplete. If the newborn suffers from lack of oxygen, a portion of brain may get damaged as the brain does not have any oxygen store. Myelination is a dynamic process that occurs during foetal life and goes on after birth in a well-defined, predetermined manner. The process is analogous to insulation of nerve fibres and is required for their proper functioning. On T1-weighted images, the pattern of myelination reaches the adult aspect at 1 year of age; on T2-weighted images, at about 2 years of age. On MR images, the last associative area to mature is considered to be the peritrigonal zone-a triangular region posterior and superior to the trigones of the lateral ventricles characterized by a persistent high signal intensity on T2-weighted images as you have mentioned. It indicates that the damage has already occurred and rather there is a lack in development. Going through the following article might be helpful: http://www.ijri.org/article.asp?issn=0971-3026;year=2002;volume=12;issue=1;spage=43;epage=50;aulast=Lakhkar Developmental support and symptomatic relief can help the child to get over her disabilities. Unless I can know the exact nature of complaints, it is hard for me to comment.