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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Does Sub Cortical White Matter In Both Frontal Lobes On FLAIR Indicate?

Hi, I recently has an MRI brain which showed a few small high intensity foci in subcortical white matter in both frontal lobes on FLAIR. I was admitted to ICU with a prodrome of viral illness for 48 hrs, then acute onset headache, vomiting and photophobia/neck stiffness and rapid reduction in GCS (14- 5). My CT head and LP were pretty normal, although I was treated for meningo-encephalitis. I was extubated after 24 hours but then went on to have a number of seizures - treated with phenytoin, keppra and lorazepam. EEG monitoring after this showed no seizure activity. After 2 weeks all my symptoms resolved and I was weaned off all the drugs. I wonder if there is any significance in MRI findings?
Fri, 6 Jun 2014
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Radiologist,  's  Response
Hello
Thanks for writing to HCM

Few small high intensity foci in subcortical white matter in both frontal lobes on FLAIR sequences are due to post infective sequel,chronic microvascular ischemic changes resulting from involvement of small blood vessels.

It is important to rule out demyelinating disease with follow up scans.
Ischemic changes resulting from blood vessels changes in diseases like hypertension,diabetes mellitus,dyslipidemia.
So,you need monitoring of conditions that leads to ischemic changes like hypertension,altered lipid profile,diabetes mellitus.
You need investigations like routine hemogram,RBS,LFT,RFT,Lipid profile,ultrasound of abdomen.
Proper treatment depend upon findings.

Hope i have answered your query.
Take Care
Dr.Indu Bhushan
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What Does Sub Cortical White Matter In Both Frontal Lobes On FLAIR Indicate?

Hello Thanks for writing to HCM Few small high intensity foci in subcortical white matter in both frontal lobes on FLAIR sequences are due to post infective sequel,chronic microvascular ischemic changes resulting from involvement of small blood vessels. It is important to rule out demyelinating disease with follow up scans. Ischemic changes resulting from blood vessels changes in diseases like hypertension,diabetes mellitus,dyslipidemia. So,you need monitoring of conditions that leads to ischemic changes like hypertension,altered lipid profile,diabetes mellitus. You need investigations like routine hemogram,RBS,LFT,RFT,Lipid profile,ultrasound of abdomen. Proper treatment depend upon findings. Hope i have answered your query. Take Care Dr.Indu Bhushan