Would You Please Interpret My Dad S MRI W/o Contrast

Posted on Sun, 25 Nov 2018

Question: Would you please interpret my Dad's MRI w/o contrast of his brain?

There is cerebral volume loss. There are scattered focal and confluent areas of signal change throughout the cerebral white matter, primarily within the right frontal periventricular distribution. There is a nonspecific finding likely due to chronic small vessel disease. There are additional nonspecific foci of signal change within the pons.

There is paranasal sinus because of thickening with right greater than left maxillary sinus mucus retention cyst. There is a small amount of fluid within the right mastoid air cells. There is mild anterolisthesis of C3 on C4. There is a disc bulge with endplate osteophytosis this level.
IMPRESSION:
1.     No acute intracranial finding.
2.     Multiple areas of signal change throughout the cerebral white matter and pons, likely due to chronic small vessel disease.
3.     Cerebral volume loss.

Answered by Dr. Ajay Panwar (8 hours later)

Brief Answer:
What are the symptoms?

Detailed Answer:
Hi Millig,
Thanks for being on healthcaremagic.com.
I am Dr.Ajay Panwar, a neurologist, here to answer your query.

Non-specific chronic small vessel changes are common at this age and does not necessarily indicate any pathologic significance. Most of the individuals of this age often show such changes in brain MRI. Maxillary mucus retention cyst and maxillary sinus fluid can be discussed with an ENT specialist. Mild anterolisthesis of C3 on C4 and disc bulges may also be frequent in this age group.

In nutshell, these findings should be observed in presence of clinical symptoms and if he does not have any complaints, nothing specific is to be done. I can provide a better advice though if you can upload his MRI images.

Hope that helps. If you have any further questions, I shall be glad to have you in follow-up.

Regards,

Dr.Ajay Panwar,
MD,DM(Neurology)

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Ajay Panwar (1 hour later)

Thanks so much for your answer! He has been experiencing an unsteadiness for the last few years - the cause has yet to be determined. He also states that he can't quite focus and closing one eye makes it easier to read the newspaper-he has been to his eye doctor multiple times who does not find any problems. Also, over the last few months, there have been some cognitive changes but he still lives independently. I don't have his MRI images, but, perhaps I can get a copy from the hospital.

Answered by Dr. Ajay Panwar (26 minutes later)

Brief Answer:
Fine. Please follow up with MRI.

Detailed Answer:
Hi Millig,
Thanks for being in follow-up.

Small vessel ischemic changes in brain may cause cognitive decline and unsteadiness.Vision issue is less likely to be due to brain changes. Its better if you can follow up with MRI images,so, that I can form a better opinion.

Hope that helps. If you have any further questions, I shall be glad to have you in follow-up.
Regards,

Dr.Ajay Panwar,
MD,DM(Neurology)

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Ajay Panwar (16 hours later)

Will try to get the images-also, on an MRI of his cervical spine, the report stated %22fluid accumulation seen in both shoulders%22. What would cause fluid accumulation in both shoulders?

Follow up: Dr. Ajay Panwar (2 minutes later)

ignore the 22%25 - I don't know why that was on there%E2%80%A6 I'm on my phone so must've been some transcription error. The report said fluid seen in both shoulders.

Answered by Dr. Ajay Panwar (4 hours later)

Brief Answer:
Consult a Rheumatologist for shoulders.

Detailed Answer:
Hi Millig,
Thanks for being in follow-up.

I must say that I am not the right person to comment on fluid in shoulders. A Rheumatologist or an Orthopaedics surgeon may better tell about the same.

Let me know if you have any further brain or spine related queries.

Regards,
Dr.Ajay Panwar,
MD,DM(Neurology)

Above answer was peer-reviewed by : Dr. Yogesh D