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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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How Can Indications Of Chronic Microvascular Ischemia And Mild Generalized Parenchymal Volume Loss Be Treated?

What is your opinion of my mri? I have seizures. Are there reasons shown here for seizures? IMPRESSION: No significant change since prior exam on 01/08/2015. No acute intracranial process. Mild senescent changes. Transcribed Using Voice Recognition Transcribe Date/Time: Feb 15 2017 8:26A Dictated by: JONATHAN LEE, MD This examination was interpreted and the report reviewed and electronically signed by: JONATHAN LEE, MD on Feb 15 2017 8:32AM EST Narrative * * *Final Report* * * DATE OF EXAM: Feb 15 2017 8:25AM EUM 0473 - MRI BRAIN WO CONTRAST / ACCESSION # 0000 PROCEDURE REASON: Severe headache R51 * * * * Physician Interpretation * * * * RESULT: MRI BRAIN WO CONTRAST History: Severe headache, dizziness. Comparison: CT head 01/07/2016. MR brain 01/08/2015. Parameters: Stroke protocol including diffusion and gradient echo images. BRAIN RESULT: Acute Ischemic Change: There is no evidence of restricted diffusion to suggest an acute infarct. Hemorrhage: No evidence of prior parenchymal hemorrhage on the gradient echo images. Mass Effect / Mass Lesion: No evidence of an intracranial mass or extra-axial fluid collection. No significant mass effect. Chronic Ischemic Change: Scattered patchy areas of increased T2 and FLAIR signal are present within the white matter, a nonspecific finding, but this likely represents chronic microvascular ischemia, not significantly changed since the prior study. Parenchyma: There is mild generalized parenchymal volume loss. Enlarged retrocerebellar CSF space is again noted which may be due to mega cisterna magna or posterior fossa arachnoid cyst, unchanged. The brain parenchyma is otherwise within normal limits of signal intensity and morphology. Ventricles: Ventriculomegaly corresponds to the degree of parenchymal volume loss. Skull Base: Hypothalamic and pituitary region are grossly normal. Craniocervical junction is normal. No significant marrow replacement process. Vasculature: Major intracranial arterial structures, and dural venous sinuses show typical flow void, suggesting patency by spin echo criteria. Other: The visualized paranasal sinuses and mastoid air cells are clear. The orbits are unremarkable. There is again atrophy of the left parotid gland. Component Results There is no component information for this result. General Information Collected: 02/15/2017 8:25 AM Resulted: 02/15/2017 8:34 AM Ordered By: Leonor M Osorio, DO, DO Result Status: Final result Back to the Test Results List Home | Site Map | Terms & Conditions | Contact Us | Log Out MyChart® licensed from Epic Systems Corporation, © 1999-2017. Patents pending.     54
Tue, 13 Nov 2018
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Neurologist, Surgical 's  Response
Hello and Welcome to ‘Ask A Doctor’ service.
I have reviewed your query and here is my advice.

Your MRI shows age related changes with generalized cerebral atrophy and compensatory ventricle enlargement. As far as your seizures are concerned,they can be there even with normal MRI. You need to go through an Ictal and Interictal EEG which will show the foci of epileptic attacks.Also you should start an anti-epileptic and get your routine blood investigations done.Seizures may be due to low sugar or electrolyte imbalance.So after doing all these preliminary investigations for epilepsy you should consult a good neurologist.

Hope I have answered your query. Let me know if I can assist you further.
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How Can Indications Of Chronic Microvascular Ischemia And Mild Generalized Parenchymal Volume Loss Be Treated?

Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. Your MRI shows age related changes with generalized cerebral atrophy and compensatory ventricle enlargement. As far as your seizures are concerned,they can be there even with normal MRI. You need to go through an Ictal and Interictal EEG which will show the foci of epileptic attacks.Also you should start an anti-epileptic and get your routine blood investigations done.Seizures may be due to low sugar or electrolyte imbalance.So after doing all these preliminary investigations for epilepsy you should consult a good neurologist. Hope I have answered your query. Let me know if I can assist you further.