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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Need Explanation Of M.R. Report In An Elderly Person

M.R. Report of my Grand Mother.
1. Bilateral fronto-parietal white matter and left external capsular regions. These are most likely to be ischemic in nature and represent changes in small vessel ischemic disease. Age Related diffuse cerebral volume loss.

2. Focal area of T2 hyper-intensity in the central pons with no changes in DWI. In view of hospitilization this may represent osmotic myelinosis amongst other differentials. Needs clinical correlation for the same.
Mon, 21 Jul 2014
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Psychiatrist 's  Response
HI THANKS FOR POSTING YOUR QUERY ON HEALTHCARE MAGIC.
GOING BY THE MRI(MAGNETIC RESONANCE IMAGING)FINDINGS OF YOUR GRAND MOTHER I WOULD LIKE TO TELL YOU THAT THE FIRST PART OF THE IMPRESSION IS QUITE COMMON IN THE ELDERLY.WITH AGE SMALL VESSELS SUPPLYING THE BRAIN TEND TO GET NARROWED RESULTING IN DIMINISHED BLOOD FLOW TO BRAIN CAUSING SO CALLED "LACUNAR INFARCTS"THESE SMALL VESSELS ARE REFFERED TO AS "LENTICOSTRIATE VESSELS.THIS INFARCTION HOLDS NO CLINICAL SIGNIFICANCE IN THE MAJORITY OF PEOPLE.
COMING TO THE SECOND PART ,THE CHANGES INDICATE PONTINE MYELINOLYSIS"THIS IS SOME WHAT A POINT TO BE WORRIED OF OR BE CONCERNED OF.THIS DESTRUCTION OF THE BRAIN MATTER IN THE PONTINE REGION OF THE BRAINSTEM, MOST COMMONLY RESULTS FROM RAPID CORRECTION OF SERUM ELECTROLYTE ABNORMALITIES BY THE CAREGIVERS IN HOSPITAL SETTING, PARTICULARY "HYPONATREMIA."THIS IS COMMON IN INTENSIVE CARE UNITS ,PARTICULARLY IN ELDERLY DUE TO OVER AMBITIOUS RAPID CORRECTION OF LOW SODIUM LEVELS OF THE BLOOD.IT COULD HAVE BEEN LARGELY PREVENTED BY SLOW CORRECTION OF SERUM SODIUM.SATISFACTORY TREATMENTS DOES NOT EXIST FOR THIS MYELINOLYSIS.CONSULT AN EXPERT NEUROLOGIST FOR FURTHER EXPLANATION.
THANK YOU.
TAKE CARE.
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Need Explanation Of M.R. Report In An Elderly Person

HI THANKS FOR POSTING YOUR QUERY ON HEALTHCARE MAGIC. GOING BY THE MRI(MAGNETIC RESONANCE IMAGING)FINDINGS OF YOUR GRAND MOTHER I WOULD LIKE TO TELL YOU THAT THE FIRST PART OF THE IMPRESSION IS QUITE COMMON IN THE ELDERLY.WITH AGE SMALL VESSELS SUPPLYING THE BRAIN TEND TO GET NARROWED RESULTING IN DIMINISHED BLOOD FLOW TO BRAIN CAUSING SO CALLED LACUNAR INFARCTS THESE SMALL VESSELS ARE REFFERED TO AS LENTICOSTRIATE VESSELS.THIS INFARCTION HOLDS NO CLINICAL SIGNIFICANCE IN THE MAJORITY OF PEOPLE. COMING TO THE SECOND PART ,THE CHANGES INDICATE PONTINE MYELINOLYSIS THIS IS SOME WHAT A POINT TO BE WORRIED OF OR BE CONCERNED OF.THIS DESTRUCTION OF THE BRAIN MATTER IN THE PONTINE REGION OF THE BRAINSTEM, MOST COMMONLY RESULTS FROM RAPID CORRECTION OF SERUM ELECTROLYTE ABNORMALITIES BY THE CAREGIVERS IN HOSPITAL SETTING, PARTICULARY HYPONATREMIA. THIS IS COMMON IN INTENSIVE CARE UNITS ,PARTICULARLY IN ELDERLY DUE TO OVER AMBITIOUS RAPID CORRECTION OF LOW SODIUM LEVELS OF THE BLOOD.IT COULD HAVE BEEN LARGELY PREVENTED BY SLOW CORRECTION OF SERUM SODIUM.SATISFACTORY TREATMENTS DOES NOT EXIST FOR THIS MYELINOLYSIS.CONSULT AN EXPERT NEUROLOGIST FOR FURTHER EXPLANATION. THANK YOU. TAKE CARE.