Yes, a black hole denotes axonal damage and is permanent. Not a good thing. The interesting (or just possibly confusing) thing here is supposedly this is a brand new lesion that they're immediately referring to as a black hole. Perhaps it was a small lesion that wasn't detected before? Who knows...

Last MRI was at the end of '07, all stable from when I was first dxed. (I had previously written 15 months so may ago so I guess that black hole has affected my ability to count! )

I am thankful for any additional information here and I really hope my neuro-op can shed some more light. A while ago I had written a thread that asked about the nature of progression -- another confusing thing is about what doctors consider normal or slow progression. Another unanswered question. I mean, can any of us really expect to NEVER see something additional on our MRI? Is that really realistic for a "progressive" disease?