I'm going with the "treat the patient, not the MRI" attitude here -- I feel okay! Still, it was not what I wanted to see on the report. Non-enhancing 8x13 mm in the right posterior frontal lobe. So from what I understand this is is permanent axonal damage, correct? Other MS "evidence" was diminished although still clear. Yup, okay, I still have MS -- I get it!

My MS specialist has not been very helpful to me so it was my neuro-op who actually ordered the brain MRI (in addition to the MRI of my orbits). I see her tomorrow so I will discuss this with her then.

Just a note about ON -- I still do consider myself very lucky but the radiologist report does confirm some atrophy although the good news is that it's stable.

Darn confusing disease! It's almost crazy that you can feel pretty much okay when these things are happening in your brain! I am very thankful that I DO feel okay -- I don't take it for granted at all. BUT -- it's still a puzzler!!!

So please tell me what you know about black holes. I will do a search on the board as well.

And lastly, as I wrote in the newest vitamin D thread, I do find it pretty interesting that I was stable for 2 years since dx and my D levels were normal during that time but I am now deficient -- and have this new lesion which they say is actually a black hole.

I'm interested in what everyone has to say about the *Black hole* thing. Are you saying that any non enhancing lesion is called such, like a slang term?

Also, I'm not up on the Vit D/ms relationship. I had read, way back, that there was some talk of a link between Vit D deficiency and people developing ms, but not having low levels and relapsing or having more lesions. Makes sense though.


I only read up on it then because as a baby I was dx'd with Ricketts - genetic Vit D deficiency.

Here is some good info on T1 black holes.

http://brain.oxfordjournals.org/cgi/...ull/126/8/1782

You remain positive and clear in your thought which is good.
I don't think there are many definitive answers to this hateful disease.
I appreciate your vit D info which is interesting but don't know (and chose not to) much about black holes and mri magic. I hope you get the answers that you search for.

Beautiful Horse, Pud's..

Why thank you !!
That's Rob a Dob. My hero.

Re: black holes, no -- any lesion can be enhancing (active) or non-enhancing, denoting new activity or not. I never really got a definitive answer on this but I believe that the period of time in which a lesion stays enhanced is roughly about 6 weeks. So in other words, at some point in the last 15 months I had an active lesion -- saying this because it's a new one. (At least according to this report.)

I had previously thought black holes were just that, like a merging of lesions together creating the hole. I didn't realize they could be lesions unto themselves, depending on how they present (not just demyelinating but indicative of axonal damage). So because of that I was surprised that it specifically said it wasn't enhanced -- didn't know that black holes could be! Sally's info. confirms the axonal damage. I'll hopefully gain some more insight from tomorrow's appointment and then decide whether or not I'm going to go back to the MS specialist this year.

Re: vitamin D (specifically D3 aka cholecalciferol) -- oh yes, there is tons of info. There's been a big surge of news on it in the last year and a half or so but I stumbled upon some interesting stuff early about D3 early on and started taking it. At the risk of being redundant, I'd suggest you start by doing a search for the previous threads in this forum -- lots of good info. Essentially, D3 functions in the body more as a hormone than a vitamin, there is evidence that deficiency is higher within the MS community and among other things, D3 helps regulate the immune system.

I also read somewhere (think I may have bookmarked it) that the blacker the black hole is, the bigger the extent of axonal damage. So gee, I wonder how black my black hole is! Maybe since they wrote it quotes ("black hole") it's just dark grayish.

I've been under the impression that a black hole is permanent. That, prior to a lesion becoming a black hole, there is a chance for re-myelination.

Is that correct?

~ Faith

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?