Examination Date: 22-09-2010
Title: MRI of the Brain
Clinical findings: chronic headaches with photophobic and nausea. brain lesion
Technique: Sagittal and coronal TSE, transversal PD + T2 + DWI ep2D
Normal appearance of both cerebral hemispheres, brain stem and cerebellum. No significant focal parenchymal abnormalities on MRI scans are identified, besides dilation of the Virchow-Robin spaces in general and some white matter, subcortical and basal ganglia T2- lesions. Ventricular system is of normal size, shape and configuration for the patient's age. Midline structures including the craniocervical junction are unremarkable. No evidence of demyelination. No evidence of cerebellar tonsillar descent. The dural venous sinuses are patent. The paranasal sinuses are clear. The orbits are normal.
There is moderate patchy mainly anterior cerebral white matter T2 suggesting minor small vessel ischaemic changes. Changes could be seen in migraine, alternatively in a small vessel vasculitis. No evidence of any subdural or subarachnoid mass lesion.
So, the doctor thinks it is the small vessel vasculitis, which puts me at increased risk of stroke, and I need to improve diet, exercise, etc. I see from the Internet that it is sometimes associated with rheumatoid arthritis, which I may well also have. I'm having another blood test for that, with the promise of a referral to a rheumatologist.