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Tuesday, April 21, 2015
Was it a stroke?
Ref my mother, 69 yoa wf, suppose to have had a stroke, I wonder more about MS. Tell me what you think of this MRI report: Multiplanar MRI exam w/o contrast. There are multifocal white matter lesions including a confluent left periventricular lesion image #16 series 71 measuring up to 2.1 cm in long axis. There is no assosciated mass effect. There are white matter lesions that extend from the subcortical region to the periventricular location. There are scattered bilateral pontine foci of increased signal. There is no diffusion abnormality to suggest recent ishemia. Ventricles, sulci and cisterns otherwise are within mornal limits for patients age. Flow void is present within the central intracranial vessels without detected aneurysm. FINDINGS: Extensive and somewhat asymmetric white matter abnomality which is snospecific and may be sequela of small vessel ischemic change without demyelinating process. There appear to be no associated mass effect. No MRI evidence of recent ischemia. I am not a doctor just well read and I know that the demyelinating is what they look for in MS. Is there anything else you read that may still point to it? Also, doesn`t this say, she didn`t have a stroke? Thank you for your time.
This question has been answered previously (see "Help Interpreting MRI result" answered 9/14). In this answer, I discussed the significance of periventricular white matter abnormalities on MRI, as well as what a stroke is. The link below will connect you to that answer. You can also return to the Ask an Expert page and use the "Search" option to find information from related questions.
MS is a disease that tends to occur in much younger patients. It is unlikely that someone 69 years old would have MS as a new diagnosis.
You did not describe your mother's symptoms, so I cannot comment on whether they are consistent with stroke. Typically, stroke symptoms are of sudden onset, whereas MS or other diseases tend to come on more gradually.
Feel free to write back if you still have questions or need an explanation.
Brett Kissela, MD
Assistant Professor of Neurology
Director, Neurology Residency Program
College of Medicine
University of Cincinnati