Can someone please help me?I just found this forum and am hoping someone can help me interpret my MRI results.

I have suffered from tension headaches and migraines for years but over the past few months they have gotten much worse with the addition of vision disturbances, dizziness, fatigue, and a bunch of other issues so my Neurologist sent me for a Brain MRI without Contrast to see what is causing mainly the headaches. My followup appointment isn't for 2 weeks but I received a copy of the report from the imaging center and am trying to make sense of it. Any help will be appreciated. I am only listing the parts that did not appear normal.

Findings:Scattered subcentimeter FLAIR hyperintensities within the periventricular and subcortical white matter. There is moderate wall thickening involving bilateral maxillary and ethmoid sinuses.

Impressions:
1.Scattered nonspecific periventricular and subcortical old white matter changes. Differential includes non specific demyelinating process such as multiple sclerosis, vasculitis, and infectious etiologies. Small vessel ischemic disease may have the appearance, but this would be atypical in patient's age group.
2.Findings consistent with chronic sinusitis involving bilateral maxillary and ethmoid sinuses.


I read this as they found 2 issues. One with my sinuses, which may be causing my headaches, and another issue which may be MS or a brain infecton?!?!?!? I am also posting this in the Headache forum because I am looking for as much input as possible.

Hello Motolady,

Welcome to our community. From what I can tell, and I am no expert, you read and interpreted this correctly. Because your neuro will have your case history, they will be in the best position to interpret the MRI and the report for you.
In the mean time, try to relax .

Hope that you get some answers and effective treatment. It sounds like you have been going through some rough times .

With love, Erika

As Erika stated, you have interpreted what is being said correctly. I will add a few things, but please keep in mind that what I am saying is worth exactly what you are paying me for it...nothing. I am just hoping to help give you information so you can talk to your doctor a little more knowledgeably. As was said, your doctor has your file, your case history, etc. and they are in the best position to tell you what it means.

It sounds from your report that you have had repeated sinus infections or inflammation, that has thickened the wall around your sinuses. You are very correct that such infections are likely to at least contribute to your headaches, if not cause them outright. Sinus infections or inflammation can also cause dizziness and visual issues in extreme cases when the inflammation impacts the nerves running to the eyes and/or inner ear. So it is entirely possible that nearly all of your symptoms are from the sinus issues alone.

With that said, fatigue, dizziness, and visual problems are also very common MS symptoms. The diagnosis of MS is not a simple matter though, as there is no smoking gun test to tell if you have it. Generally it is a process of elimination where the doctors rule out other possibilities one at a time until either MS or some other disorder is the last thing standing. There are certain areas of the brain that "lesions" or what you may see described on an MRI as "hyperintensities" are commonly found in folks with MS. The ventricular and periventricular white matter is one of those areas. Hyperintensities can also show up in those areas from other things...such as leaky blood vessels (vasculitis or small vessel ischemic disease) or damage relating to an infection that has crossed the blood-brain barrier. Vasculitis generally shows up more commonly in older adults, while MS usually manifests in people under 35, hence the radiologist's comments about age groups and which is likely. I am not saying that the report says you have MS, so please don't freak out. All that the radiologist is saying is that he or she sees bright spots in your scan, and the most common cause of those type of spots in those locations is a disease like MS that damages myelin. It is up to your doctor (hopefully a neurologist) to take that information and correlate it with other test results, compare it to your clinical symptoms, and decide from there whether more testing is needed or if there is a diagnosis that fits.

Before discussing this report with a doctor, you may want to google the "McDonald Criteria" for diagnosing MS. It has some specific guidelines that doctors use to determine if a patient should be diagnosed with MS. It will talk about the number and locations of lesions, the timeframe of symptoms and whether you have had more than one episode, and whether those episodes are separated by specific amounts of time. Don't be surprised if you go to the doctor and they say "it could be MS, but we don't know yet". If this is the first time you have seen a doctor about this list of symptoms and the first time they have done an MRI, you likely would not meet the McDonald Criteria. Diagnosing MS can be a long process and may take more than one MRI, more blood tests, and perhaps a lumbar puncture (spinal tap) to sample cranial-spinal fluid (CSF) for markers specific to MS. Some people go years with no diagnosis and end up finding out it isn't MS, others may be diagnosed in 6 months or less. So be prepared for a long process whether you have MS or something totally different. Just be patient and ask alot of questions to make sure you understand what they are telling you.

Most of all, regardless of what it turns out to be, don't let your diagnosis rule your life. There are people with MS who have had very difficult paths, and there are others who are largely symptom free for many years at a time. Be patient with your doctors and ask lots of questions, but be positive about your life and your future, no matter what they tell you. And most of all, come back and let us know how it goes. There is a very supportive group of folks here, and we don't bite...much!