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What Does This MRI Report Of Brain Indicate?
Question: My mother, 61, is a renal transplant rejection patient and on dialysis since 3 months through jugular catheter. She was suffering from hearing loss for a about 1.5 yrs; the doctor concluded it was fluid in middle ear. We did not go for surgery and opted for hearing aid. But from past 2 months she has problem walking (balancing). Apart from that, her head just loses control and falls when looking up or down. MRI of head revealed 1) Symmetric increase in bilateral T1WI hyper-intensity involving to globus pallidus and substantia nigra. No mass effect / no restricted DWI / no hemorrhage.
2) Bilateral ischemic WM changes.
3) Bilateral mastoid effusion noted. (right > left).
Kindly translate these in simple way if possible and suggest the mode of treatment. What could she be suffering from.
2) Bilateral ischemic WM changes.
3) Bilateral mastoid effusion noted. (right > left).
Kindly translate these in simple way if possible and suggest the mode of treatment. What could she be suffering from.
Brief Answer:
Her dizziness and hearing loss may be due to multiple causes.
Detailed Answer:
Hi,
Thank you for your query.
1. Long standing conditions such as diabetes, hypertension, renal disease, dialysis, otitis media with effusion (OME) are all individually capable of causing hearing loss. The exact mechanisms are unknown. Age related hearing loss is also expected in her case.
2. Get a Pure Tone Audiogram and an Impedance Audiogram (Tympanometry) done. This will help differentiate the type of hearing loss.
3. Any sensorineural hearing loss of component thereof may be multi-factorial.
4. Any conductive hearing loss or component thereof can be easily treated with a myringotomy and grommet insertion. Long standing fluid in the middle ear tend to thicken like glue and hence only medication may not help drain it.
5. The dizziness has to be differentiated between BPPV (Benign Paroxysmal Positional Vertigo), Meniere's, Labyrinthitis and central (brain-related ) causes. This will require direct examination and tests.
6. It will be better to start medication for dizziness after her examination and tests as these medications suppress the signs.
If you have any more questions I will be available to answer them.
Regards.
Her dizziness and hearing loss may be due to multiple causes.
Detailed Answer:
Hi,
Thank you for your query.
1. Long standing conditions such as diabetes, hypertension, renal disease, dialysis, otitis media with effusion (OME) are all individually capable of causing hearing loss. The exact mechanisms are unknown. Age related hearing loss is also expected in her case.
2. Get a Pure Tone Audiogram and an Impedance Audiogram (Tympanometry) done. This will help differentiate the type of hearing loss.
3. Any sensorineural hearing loss of component thereof may be multi-factorial.
4. Any conductive hearing loss or component thereof can be easily treated with a myringotomy and grommet insertion. Long standing fluid in the middle ear tend to thicken like glue and hence only medication may not help drain it.
5. The dizziness has to be differentiated between BPPV (Benign Paroxysmal Positional Vertigo), Meniere's, Labyrinthitis and central (brain-related ) causes. This will require direct examination and tests.
6. It will be better to start medication for dizziness after her examination and tests as these medications suppress the signs.
If you have any more questions I will be available to answer them.
Regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thankyou doctor,
If you could have a look, I have many attached reports CT, MRI, blood tests, kidney Biopsy, audiogram etc. The ENT and Neuro appointments are not until next week; appointments are hard to get. So, providing me with knowledge will get me prepared to face the doctors and sort out her issues earlier. Presently she is with neuro dept (referred to by ENT); after they clear her ENT will concentrate on her; that is what i was informed.
What i can give you is her BP is never below 170/80 (max 210/100; avg 185/85 or so). Blood sugar morning 160, 2 hr after lunch 275, at dinner 220; insulin novo mix (morning evening) and novo rapid (afternoon); sliding scale.
Creatinine 5 to 5.5; urea 60 to 80; potassium 5 (reading just before dialysis); hemoglbin 6.5, rbc 2.35 (now almost 6 months on erythropoetin 3000iu 3 times a week).
Thankyou
If you could have a look, I have many attached reports CT, MRI, blood tests, kidney Biopsy, audiogram etc. The ENT and Neuro appointments are not until next week; appointments are hard to get. So, providing me with knowledge will get me prepared to face the doctors and sort out her issues earlier. Presently she is with neuro dept (referred to by ENT); after they clear her ENT will concentrate on her; that is what i was informed.
What i can give you is her BP is never below 170/80 (max 210/100; avg 185/85 or so). Blood sugar morning 160, 2 hr after lunch 275, at dinner 220; insulin novo mix (morning evening) and novo rapid (afternoon); sliding scale.
Creatinine 5 to 5.5; urea 60 to 80; potassium 5 (reading just before dialysis); hemoglbin 6.5, rbc 2.35 (now almost 6 months on erythropoetin 3000iu 3 times a week).
Thankyou
Brief Answer:
Neuro treatment first, Myringotomy & grommet, further treatment.
Detailed Answer:
Hi,
Thank you for writing back.
1. It is better for the Neuro team to treat her first.
2. Once she stabilizes, get her Myringotomy and grommet insertion done in both ears.
3. There rest is as expected given her current medical condition.
4. Upload the Pure Tone Audiogram (PTA) which is on the back of the Impedance Audiometry report.
If you have any more questions I will be available to answer them.
Regards.
Neuro treatment first, Myringotomy & grommet, further treatment.
Detailed Answer:
Hi,
Thank you for writing back.
1. It is better for the Neuro team to treat her first.
2. Once she stabilizes, get her Myringotomy and grommet insertion done in both ears.
3. There rest is as expected given her current medical condition.
4. Upload the Pure Tone Audiogram (PTA) which is on the back of the Impedance Audiometry report.
If you have any more questions I will be available to answer them.
Regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi, I have provided some attachments. Please review them.
Brief Answer:
No new attachments.
Detailed Answer:
Hi,
Thank you for writing back.
There are no new attachments, only the previous 10 attachments
If you have any more questions I will be available to answer them.
Regards.
No new attachments.
Detailed Answer:
Hi,
Thank you for writing back.
There are no new attachments, only the previous 10 attachments
If you have any more questions I will be available to answer them.
Regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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