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What Does This MRI Of Brain And ECHO Report Indicate?
Question: Respected Sir,
Respected Sir, DrXXXXXX , Cardiologist, one of your team doctors, suggested me to get my MRI evaluated by a neurologist to get second opinion. Thats why i am asking this question. KINDLY RFFER THIS TO A NEUROLOGIST OF YOUR TEAM AND OBLIGE. Is there any serious abnormality in the report/my condition. I was hospitalised with High BP and Sugar level. But now my sugar level is normal since 14th Oct.2014 (Fasting sugar level will be always below 90mg/dl) and Random blood sugar varies from 103 to 133 mg/dl (depending upon my eating any fruits /or coffee etc). My present BP level is 121/82/77 at 9.20am and it was 108/80/77 at 6.15 am today. Diastolic increases sometimes during the day. it has reached upto 84 ; otherwise it will be upto 80 or below 80. during morning hours. I have gone through BRAIN MRI, HEART ECOCARDIOGRAM, U/S OF ABDOMEN, BLOOD COUNT TEST, ECG, DOPPLER TEST FOR ARTERIES. (NEAR NECK).
I HEREBY GIVE MY LAB IMPRESSIONS :
HYPERTENSION, DYSLIPEDEMIA, HYPOTHYROIDISM, ATHERO SCLEROTIC CAROTID ARTERY STENOSIS BILATERAL 10% NARROWING, ISCHEMIC CEREBROVASCULAR ACCIDENT IN THE REGION OF CORONA RADIATA WITH NO MAJOR NEUROLOGICAL DEFICIT.
2D ECHO - NORMAL .
CAROTID DOPPLER STUDY - BOTH ICA ARE TORTUOUS, SMALL CALCIFIED PLAQUE MEASURING 0.18X0.10CMS IN LEFT ICA CAUSING ABOUT 5-10% STENOSIS. NO EVIDENCE OF STENOTIC PLAQUES ON THE RIGHT SIDE. NORMAL ANTEGRADE FLOW IS SEEN IN BOTH VERTEBRAL ARTERIES.
BLOOD COUNT - HAEMOGLOBIN - 14.5 GM%, ESR(1HR) 25, RBC COUNT 4.44,
LIVER FUNCTION TEST - SERUM BILIRUBIN DIRECT - 0.15, ALBUMIN 4.8 GM/DL.
RENAL FUNCTION TEST - BLOOD UREA - 13.8 MG/DL . TROPONIN TEST - NEGATIVE.
THYROID TEST - TSH 12.06.
LIPID PROFILE - TOTAL CHOL - 211.3, HDL 43.5, LDL 156.1, VLDL - 11.7.
HB A1C - 5.9%.
BRAIN MRI -
CIRCUMSCRIBED ROUNDED FOCUS OF T2 WEIGHTED, T2 TIRM AND T2 HAEMO NON RESTRICTING HYPERINTENSITY ACROSS THE LEFT-SIDED CORONA RADIATA - ISCHEMIC. OTHER THINGS NORMAL.
Asked by Me , 1 hour ago
Respected Sir, DrXXXXXX , Cardiologist, one of your team doctors, suggested me to get my MRI evaluated by a neurologist to get second opinion. Thats why i am asking this question. KINDLY RFFER THIS TO A NEUROLOGIST OF YOUR TEAM AND OBLIGE. Is there any serious abnormality in the report/my condition. I was hospitalised with High BP and Sugar level. But now my sugar level is normal since 14th Oct.2014 (Fasting sugar level will be always below 90mg/dl) and Random blood sugar varies from 103 to 133 mg/dl (depending upon my eating any fruits /or coffee etc). My present BP level is 121/82/77 at 9.20am and it was 108/80/77 at 6.15 am today. Diastolic increases sometimes during the day. it has reached upto 84 ; otherwise it will be upto 80 or below 80. during morning hours. I have gone through BRAIN MRI, HEART ECOCARDIOGRAM, U/S OF ABDOMEN, BLOOD COUNT TEST, ECG, DOPPLER TEST FOR ARTERIES. (NEAR NECK).
I HEREBY GIVE MY LAB IMPRESSIONS :
HYPERTENSION, DYSLIPEDEMIA, HYPOTHYROIDISM, ATHERO SCLEROTIC CAROTID ARTERY STENOSIS BILATERAL 10% NARROWING, ISCHEMIC CEREBROVASCULAR ACCIDENT IN THE REGION OF CORONA RADIATA WITH NO MAJOR NEUROLOGICAL DEFICIT.
2D ECHO - NORMAL .
CAROTID DOPPLER STUDY - BOTH ICA ARE TORTUOUS, SMALL CALCIFIED PLAQUE MEASURING 0.18X0.10CMS IN LEFT ICA CAUSING ABOUT 5-10% STENOSIS. NO EVIDENCE OF STENOTIC PLAQUES ON THE RIGHT SIDE. NORMAL ANTEGRADE FLOW IS SEEN IN BOTH VERTEBRAL ARTERIES.
BLOOD COUNT - HAEMOGLOBIN - 14.5 GM%, ESR(1HR) 25, RBC COUNT 4.44,
LIVER FUNCTION TEST - SERUM BILIRUBIN DIRECT - 0.15, ALBUMIN 4.8 GM/DL.
RENAL FUNCTION TEST - BLOOD UREA - 13.8 MG/DL . TROPONIN TEST - NEGATIVE.
THYROID TEST - TSH 12.06.
LIPID PROFILE - TOTAL CHOL - 211.3, HDL 43.5, LDL 156.1, VLDL - 11.7.
HB A1C - 5.9%.
BRAIN MRI -
CIRCUMSCRIBED ROUNDED FOCUS OF T2 WEIGHTED, T2 TIRM AND T2 HAEMO NON RESTRICTING HYPERINTENSITY ACROSS THE LEFT-SIDED CORONA RADIATA - ISCHEMIC. OTHER THINGS NORMAL.
Asked by Me , 1 hour ago
Brief Answer:
It is due to hypertension,dyslipidemia & diabetes.
Detailed Answer:
Hello XXXXXX
I have thoroughly gone through your reports in detail.
Findings are due to metabolic disorders like hypertension,diabetes mellitus and dyslipdemia.
In MRI(Brain),T2 weighted tiny hyper intensities less than five in number in deep white matter of brain can be ignored.
Mostly it is due to ischemic changes(decreased blood supply) that involves small blood vessels.However demyelination,post traumatic sequel should also be ruled out with follow up scans.Diabetes mellitus and altered lipid profile also aggravates the situation.
You need regular monitoring of conditions that leads to ischemic changes like hypertension,altered lipid profile,diabetes mellitus.
Carotid doppler findings are also due to hypertension,dyslipidemia and diabetes mellitus.Findings are not so severe that it require intervention.It is good that now you have controlled hypertension and diabetes mellitus.
But lipids are still raised.It need to control.
Findings also suggest raised TSH,this condition need medicines like eltroxin after proper evaluation.
Get well soon.
Hope i have answered your query.
Further queries are most welcome.
Take Care
Dr.Indu XXXXXXX
It is due to hypertension,dyslipidemia & diabetes.
Detailed Answer:
Hello XXXXXX
I have thoroughly gone through your reports in detail.
Findings are due to metabolic disorders like hypertension,diabetes mellitus and dyslipdemia.
In MRI(Brain),T2 weighted tiny hyper intensities less than five in number in deep white matter of brain can be ignored.
Mostly it is due to ischemic changes(decreased blood supply) that involves small blood vessels.However demyelination,post traumatic sequel should also be ruled out with follow up scans.Diabetes mellitus and altered lipid profile also aggravates the situation.
You need regular monitoring of conditions that leads to ischemic changes like hypertension,altered lipid profile,diabetes mellitus.
Carotid doppler findings are also due to hypertension,dyslipidemia and diabetes mellitus.Findings are not so severe that it require intervention.It is good that now you have controlled hypertension and diabetes mellitus.
But lipids are still raised.It need to control.
Findings also suggest raised TSH,this condition need medicines like eltroxin after proper evaluation.
Get well soon.
Hope i have answered your query.
Further queries are most welcome.
Take Care
Dr.Indu XXXXXXX
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Respected Sir,
I am taking THYRONORM 50 mcg as per doctor advise (after discharge from the hospital - Attending doctor he himself suggested this medicine.
But you are suggesting to take Eltroxin tablets. whether both are same?
My sugar level (fasting) will be always below 90 mg/dl. Regarding other tablets i am taking Rozustat 20 mg, Clopilet A (aspirin included) daily after dinner and Stmilo 2.5 mg tablet daily after breakfast.
Dr.Anantharamakrishnan , Cardiologist, one of your team doctors, suggested me to get my MRI evaluated by a Neurologist. So, i addressed my problem once on this forum.
Any other method to get my reduce my hypertension/lipids, apart from medications which i am taking? kindly guide.
I am taking THYRONORM 50 mcg as per doctor advise (after discharge from the hospital - Attending doctor he himself suggested this medicine.
But you are suggesting to take Eltroxin tablets. whether both are same?
My sugar level (fasting) will be always below 90 mg/dl. Regarding other tablets i am taking Rozustat 20 mg, Clopilet A (aspirin included) daily after dinner and Stmilo 2.5 mg tablet daily after breakfast.
Dr.Anantharamakrishnan , Cardiologist, one of your team doctors, suggested me to get my MRI evaluated by a Neurologist. So, i addressed my problem once on this forum.
Any other method to get my reduce my hypertension/lipids, apart from medications which i am taking? kindly guide.
Brief Answer:
Please find detail answer below.
Detailed Answer:
Hello XXXXXXX
Thyronorm contains eltroxin,so these are same.
You get getting maximum medications.Additionally you need diet and life style modification.
You should try to increase your physical activity and go for brisk walk.
Avoid fried and fatty food.Avoid red meat and fatty milk products.
Cook food in olive or canola oil.
If lipid profile is persistently raised even with medicines and life style modification then tablet fenofibrate can be added.Combination of atorvastatin and fenofibrate better maintain lipid profile.
Rest of the findings are acceptable.
Get well soon.
Hope i have answered your query.
Further queries are most welcome.
Take Care
Dr.Indu XXXXXXX
Please find detail answer below.
Detailed Answer:
Hello XXXXXXX
Thyronorm contains eltroxin,so these are same.
You get getting maximum medications.Additionally you need diet and life style modification.
You should try to increase your physical activity and go for brisk walk.
Avoid fried and fatty food.Avoid red meat and fatty milk products.
Cook food in olive or canola oil.
If lipid profile is persistently raised even with medicines and life style modification then tablet fenofibrate can be added.Combination of atorvastatin and fenofibrate better maintain lipid profile.
Rest of the findings are acceptable.
Get well soon.
Hope i have answered your query.
Further queries are most welcome.
Take Care
Dr.Indu XXXXXXX
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Respected Sir, thanks for reply/guidance.
1. I am a vegetarian. no smoking/drinking habits.
2. whether i have to avoid butter-milk and skimmed milk also?
3. I am having constipation problem (i get little light headeness before bowel).
4. We are using sun-flower oil. ok?
5. I feel diziness/weakness during after noon that too after 3-4 hours after lunch. I feel i will be unable to walk during that time. After taking some food/light coffee etc; i will become normal.
kindlyguide.
1. I am a vegetarian. no smoking/drinking habits.
2. whether i have to avoid butter-milk and skimmed milk also?
3. I am having constipation problem (i get little light headeness before bowel).
4. We are using sun-flower oil. ok?
5. I feel diziness/weakness during after noon that too after 3-4 hours after lunch. I feel i will be unable to walk during that time. After taking some food/light coffee etc; i will become normal.
kindlyguide.
Brief Answer:
Please find detail answer below.
Detailed Answer:
Hello XXXXXXX
It is good that you are vegetarian and you don't have smoking/drinking habits.
You can take skimmed milk.
You should increase fibre intake for constipation.
It is better to take canola or olive oil.
Your symptoms of dizziness/weakness is due to hypoglycemia.You should take food in small amount and at regular interval.
Get well soon.
Hope i have answered your query.
Further queries are most welcome.
Take Care
Dr.Indu XXXXXXX
Please find detail answer below.
Detailed Answer:
Hello XXXXXXX
It is good that you are vegetarian and you don't have smoking/drinking habits.
You can take skimmed milk.
You should increase fibre intake for constipation.
It is better to take canola or olive oil.
Your symptoms of dizziness/weakness is due to hypoglycemia.You should take food in small amount and at regular interval.
Get well soon.
Hope i have answered your query.
Further queries are most welcome.
Take Care
Dr.Indu XXXXXXX
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
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