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Abnormal brain MRI scan

Ivana

Senior Member
Messages
112
Hi all,

I've got no idea which category to put this under, so I'll write it here.

I've just received my brain MRI results which weren't perfectly normal. I was wondering if anyone knows what this means:

Conclusion:
Several small non-specific supratentorial white matter FLAIR hyperintensities are noted. The possibility of underlying primary demyeliniation cannot be excluded. The differential diagnosis may include underlying migranious process or chronic small vessel vasculopathy (e.g. vasculitis). Clinical correlation is suggested.

Any ideas?

Ivana
 

Enid

Senior Member
Messages
3,309
Location
UK
Ten years ago my battery of tests from my Neurologist (I was very ill at the time and mostly bed- bound) showed what sounds very similar give or take differing terminology. My MRI brain scan showed "patchy high signals" and 2 other abnormalities found - serum ACE of 56 (the serum ACE performed was 68) and a weak anti-smooth muscle antibody 1/640. No conclusion was drawn but I think the former finding has to do with blood supply (angio converting enzyme ?) and the latter a sign of chronic infection (even an autoimmunity). Demyelisation was considered (MS and Parkinsons ruled out). Though I can't aid in diagnosis I do note that there is current thinking that these "high spots" do have to do with vascular problems (blood supply). However from the severity of that stage (I couldn't put a sentence together) cognitive problems are vastly improved now so no permanent damage. Did you have a lumbar puncture - I did and note the interesting information about abnormal proteins found in the spinal fluid - See kms 1990 thread "just finished cerebrospinal fluid study" .
 

jace

Off the fence
Messages
856
Location
England
Enid's MRI experience, and improvement since, mirrors my own. My MRI showed multiple high intensity small bright objects, or some such terminology. In my case, it was put down to drinking alcohol (which I could not do at all at the time :eek:) and age - not quite 60.
 

xchocoholic

Senior Member
Messages
2,947
Location
Florida
I had these to but they resolved via the gf diet. I'm not sure how common these are with gluten intolerance.
If I'm not mistaken, dr wahls had these too but they're gone now.

My cognitive skills have improved dramatically over the last 7 years. I'm assuming from diet. Allergies, hypoperfusion,
meds or supplements for sleep, etc still cause cognitive problems of course.

Tc .. X
 

Sherlock

Boswellia for lungs and MC stabllizing
Messages
1,287
Location
k8518704 USA
Hi, at first that seems scary but this study from 1997 says that it's not related to CFS:

"Fazekas (18) studied 87 healthy volunteers
and described white matter lesions in 11% of
subjects aged 0 to 39 years, in 31% of subjects
aged 40 to 49 years, in 47% of those aged 50 to
59 years, in 60% of those aged 60 to 69 years,
and in 83% of those aged 70 years and over,
consistent with our findings in the control group.
In seven patients of our study group, MR findings
were likely to be age related, reflecting a
vasculopathy involving the small vessels of the
white matter. Hendrie et al (20) identified such
MR abnormalities in 59% of healthy subjects
over the age of 63 years without risk factors or
deficits in cognitive function, and in all subjects
over the age of 75 years."

http://www.ajnr.org/content/18/7/1265.full.pdf

But that was a while ago so I looked some more. The subject of looking at white matter in MRI hasn't been pursued much since back then, so that supports the idea that it isn't so relevant, except maybe as a red flag in younger people. This 2008 review:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3044887/?tool=pubmed

also doesn't discuss any more specific recent followups on white matter. (There is a relatively short section of 5 paragraphs relating to CFS.) However, they do point to this study:

http://brain.oxfordjournals.org/content/131/8/2172.long#ref-15

which claims an association found using computer analysis between those kinds of hyperintensities and reduced gray matter volume (shrunken brain). How van a person try to reverse the shrinking of the brain? Maybe CBT

"Increase in prefrontal cortical volume following cognitive behavioural therapy in patients with chronic fatigue syndrome"

quick summary: CFS brains are 5% smaller than healthy ones, and CBT might reverse that somewhat, whereas CBT does nothing for healthy brains. The area mainly involved is the lateral prefrontal cortex.
 

*GG*

senior member
Messages
6,389
Location
Concord, NH
I had this test done also, but nothing was noted of significance. But I think this depends upon who reads it, correct?

GG
 

Gamboa

Senior Member
Messages
261
Location
Canada
I have had two MRI's in the last few years a in both I had multiple small areas of hyper-intensity in both frontal lobes. The report said it correlates with a history of migraine headaches but my doctor at the moment, Dr. Byron Hyde, said they are commonly found in people with ME/CFS.

In the book "Osler's Web" ME/CFS doctors noted a large number of their patients had these small "UBO's" ( unidentified bright objects).

I don't think enough research has been done into this.
 

Ivana

Senior Member
Messages
112
thank you all for your responses.. I got worried as i am quite young so i knew it couldnt be age related.. I hear its very common in MS, i might go see the neurologist sooner than my next appt if i can get one.. Bit tough though coz he doest beleive in m.e
 

Enid

Senior Member
Messages
3,309
Location
UK
Well very late hypothyroid diagnosis for me preceding ME taking relatively high thyroxine dosage initially to stabilise. But I don't trust their current tests and certainly know Docs do not understand the implications in all other systems for thyroid insufficiency and delayed diagnosis.
 

Sherlock

Boswellia for lungs and MC stabllizing
Messages
1,287
Location
k8518704 USA
i might go see the neurologist sooner than my next appt if i can get one.. Bit tough though coz he doest beleive in m.e
but he certainly does believe in MS and so he'll want to investigate if your scan is showing the typical demyelination, so I'd guess you get the appt for that other reason :)
 

taniaaust1

Senior Member
Messages
13,054
Location
Sth Australia
The differential diagnosis may include underlying migranious process or chronic small vessel vasculopathy (e.g. vasculitis). Clinical correlation is suggested.

Any ideas?

Ivana

Vasculitis was a common finding in at least one of the past big ME outbreaks. So it can be all related to this illness.
 

taniaaust1

Senior Member
Messages
13,054
Location
Sth Australia
I have had two MRI's in the last few years a in both I had multiple small areas of hyper-intensity in both frontal lobes. The report said it correlates with a history of migraine headaches but my doctor at the moment, Dr. Byron Hyde, said they are commonly found in people with ME/CFS.

In the book "Osler's Web" ME/CFS doctors noted a large number of their patients had these small "UBO's" ( unidentified bright objects).

I don't think enough research has been done into this.

The Adelaide Research Group (in Sth Australia) was doing MRIs and stuff for ME/CFS and looking at these. As far as I know they are still doing some ME/CFS research (their area of interest was in MRIs, EEGs and autonomic dysfunctions with ME/CFS) .

(They seem to be slow when it comes to publishing their findings.. a study I was in wasnt published in an medical journal till several years later but I expect to see more follow up studies coming out from them sometime in the next couple of years).