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What Does The MRI Of The Head Indicate?
Question: I am female, 61 yrs. old. Had a severe concussion in 1969 (unconscious for a wk. to 10 days). Came off a galloping horse - helmet dented and came off. Horse fine. Me, not so much. Have had daily headaches for 45 yrs. Tension, migraine, "weather", sinus, "weather", etc. A head MRI last wk. says "a few punctate areas of increased signal within the subcortical white matter but without mass effect high on flair." Also, "on the SWI sequence, there is an area of low signal seen within the parasagittal aspect, likely within the anterior body of the corpus callosum, a low signal areas seen compatible with an area of remote hemorrhage, with some corresponding areas of low signal on the T2 sequence, measuring up tp 6 mm." Impression: "Non-specific areas of increased signal is seen within the subcortical white matter without mass effect most likely remote ischemic change. There is an area of remote hemorrhage seen of the anterior body of the corpus callosum." What the heck does this mean?
I was told I had optic nerve pallor and abnormal reflexes, as well.
I was told I had optic nerve pallor and abnormal reflexes, as well.
Brief Answer:
Chronic changes post concussion or encephalitis.
Detailed Answer:
I read your question carefully and I understand your concern and confusion.
Those findings on MRI are not that specific. There are scattered very small areas of change, but they don't represent a new lesion, they are remnants of old lesions, sort of like small scars.
The reasons for those old lesions could be many. The report considers chronic ischemic changes as most probable and that would generally be true for someone over 60. However reading your history the cause could be the old concussion or also the severe encephalitis you described, both could leave those remains.
The other finding is also a small area of hemorrhage in a structure of the brain called corpus callosum (it connects the brain hemispheres). That is also an old injury not a recent one. Might be a remnant of the concussion although after such a long time I am not sure any sign of hemorrhage should be left. Perhaps a follow-up MRI in a year might be indicated to re-evaluate it in order to exclude some vascular malformation. Too small to cause the headache though.
As for your signs of optic nerve pallor and increased reflexes, they are well compatible with residual damages from your concussion too.
So whether this MRI does provides new data to change much in your headache management...I am afraid not. Those are chronic changes, expected to a degree considering your history, which don't indicate why your headache has worsened lately.
If your chronic headaches started after the concussion, it corresponds probably to the type of headache called Chronic Post-traumatic Headache attributed to Mild or Severe Head Injury, a type of chronic headache with not completely explained mechanisms, attributed both to anatomic injury from widespread nerve fibers stretching and tearing as well as to psychological factors.
I hope to have been of help.
Chronic changes post concussion or encephalitis.
Detailed Answer:
I read your question carefully and I understand your concern and confusion.
Those findings on MRI are not that specific. There are scattered very small areas of change, but they don't represent a new lesion, they are remnants of old lesions, sort of like small scars.
The reasons for those old lesions could be many. The report considers chronic ischemic changes as most probable and that would generally be true for someone over 60. However reading your history the cause could be the old concussion or also the severe encephalitis you described, both could leave those remains.
The other finding is also a small area of hemorrhage in a structure of the brain called corpus callosum (it connects the brain hemispheres). That is also an old injury not a recent one. Might be a remnant of the concussion although after such a long time I am not sure any sign of hemorrhage should be left. Perhaps a follow-up MRI in a year might be indicated to re-evaluate it in order to exclude some vascular malformation. Too small to cause the headache though.
As for your signs of optic nerve pallor and increased reflexes, they are well compatible with residual damages from your concussion too.
So whether this MRI does provides new data to change much in your headache management...I am afraid not. Those are chronic changes, expected to a degree considering your history, which don't indicate why your headache has worsened lately.
If your chronic headaches started after the concussion, it corresponds probably to the type of headache called Chronic Post-traumatic Headache attributed to Mild or Severe Head Injury, a type of chronic headache with not completely explained mechanisms, attributed both to anatomic injury from widespread nerve fibers stretching and tearing as well as to psychological factors.
I hope to have been of help.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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