What Does This CT Scan Report Indicate?

Posted on Thu, 17 Aug 2017

Question: I just had a brain CT Scan to look for possible internal brain bleeding connected to an occlusion found by a retina specialist during an eye examination. In the conclusions, the radiologists say: IMPRESSION:

1. There is no evidence of acute intracranial hemorrhage or acute transcortical infarct.

2. Atrophy and leukomalacia.
They also list in the findings: FINDINGS:

Ventricles:Unremarkable.

Basal Cisterns:Unremarkable.

Cortical Sulci:Atrophy.

Cerebrum:Nonspecific hypoattenuation along the deep white matter and periventricular regions.

Cerebellum:No mass, intracranial hemorrhage or acute territorial infarct.

Brainstem:Unremarkable.

Sinuses/Mastoid: The paranasal sinuses and mastoid air cells are clear.

Scalp & Skull: Unremarkable.
I am suffering from neuropathy. Feet, ankles, toes are numb. I also experience burning in my feet, and itching in my hands (same way it started on my feet). Are the leukomalacia, and cortical suicci atrophy, together with hypoattenuation of the deep white matter in need of further evaluation by neurologist. My primary doctor indicates no reason to worry. I am 77 years old, take HBP medication, had an infarction in 2004 and CBG performed. I have several stents in my coronaries. Should I return to a neurologist for further diagnoses. Blood tests all look normal. I take B2. I have a progressing imbalance problem.

Answered by Dr. Olsi Taka (51 minutes later)

Brief Answer:
No reason to worry about CT findings

Detailed Answer:
I read your question carefully and I understand your concern.

I tend to agree with your primary physician. As we age some changes in the brain are found in the brain. Atrophy in particular is something that happens for all of us, after the age of 30 us all lose some brain mass year after year, as it accumulates it becomes visible on scans. While there are variations in its rate it happens for all of us, it's part of aging. At the age of 77 you provide it is to be expected.
As for the changes in the white matter they are very common as well, they happen due to changes in blood vessel walls, which can lead to occlusion of the tiniest vessels and small scattered areas of damage in the white matter. While not as universal as atrophy such changes are common as well with age. They are not desirable naturally, but when in mild or moderate stages shouldn't cause any symptoms, only in advanced stages (doesn't look like it from the report).
Partly they are genetically determined, partly they are accelerated by factors which damage blood vessels such as high blood pressure, diabetes, smoking etc. So the only thing which can be done to slow done their appearance and progression is addressing those factors.

So if you mean to go to the neurologist regarding those CT findings I would say it is not necessary, there is not much more than the neurologist will do for you. If you mean to go to neurologist for neuropathy that is a different issue, if the cause is unknown neurological consult and tests may be needed, CT doesn't aid much in neuropathy diagnosis. The changes in the report are not related to the neuropathy.

I remain at your disposal for other questions.

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