I know no one here are doctors but if someone can help me understand this MRI I would sure appreciate it. I do have an appt set to go over results but am anxious.

The cortical sulci, cisterns and ventricles are proportionate in size and not
enlarged. There is a mild to moderate burden of nonspecific nodular
periventricular, deep and subcortical white matter foci of T2 prolongation.
There is T2 signal hyperintensity within the brainstem particularly involving
the pons. These findings are more than expected for a patient of this age. No
hemorrhage, mass, midline shift, extra fluid collections or restricted
diffusion. Normal intracranial flow voids.
The orbital contents are unremarkable. There is minimal paranasal sinus mucosal
thickening. Normal nasopharyngeal soft tissues. Partially visualized cervical
spine hardware.
Impression:
No evidence of acute intracranial disease.
Mild to moderate burden of nonspecific white matter T2 prolongation, and
significant T2 signal hyperintensity within the pons and brainstem. These
findings may be secondary to early manifestations of chronic small vessel
ischemia and brainstem ischemic gliosis. Demyelinating disease and other
etiologies are also considerations, in the appropriate clinical setting.


Thank you in advanc4

Sorry I didn't provide more information on my 1st post. That's probably why no one responded.

So... I don't see my surgeon to go over this until the 26th.

This is my Brain MRI that my Neuro Dr ordered. My surgeon sent me to her among other specialists because I'm having so many problems after my DLIF surgery. L1 to L5 fusion. A very painful surgery! I am just over 8 months in.

I think my surgeon is seeking nerve damages.

I have seen a Neuro, Gastro and Urologist so far and each of them are ordering more tests. It's been very frustrating because I don't what's gone wrong with my body.

If anyone here has any idea what any of the MRI means...anything...I would sure appreciate it. Again, I know no one here is a doctor, just seeking for anything!

Thank you

Is anyone reading this? Maybe my title line was the wrong description for this topic. So I reworded it above to Brain MRI After DLIF 4 level Back Surgery.

I hope someone may be able to respond this time.

Thank you in advance for any replies.

Hi Moonstar,
I'm sorry you are going through this and having to wait to see your doctor, waiting and guessing is so difficult.

I think part of the issue is not knowing what symptoms you are having. Test results are best analyzed in the context of symptoms, so let us know what symptoms you are dealing with. Do you have other tests that will be performed? It mentioned white matter more than what should have for your age. Have the docs mentioned anything specific they are looking for?

I know, no answers, but I wanted to reply. I've been the one waiting & worrying, & probably will be again!

Hi Jenng,
I was also confused as to why I even needed a brain MRI. I believe it's because I have a serious gait problem or maybe the Neuro Dr was checking if my brain is talking to my body correctly for nerve signals & pain generators or because I have a bladder problem that involves nerve damage or possibly to check for MS. Right now I'm not sure because I'm having so many issues after I had my lumbar surgery. Maybe it's because there may be nerve damages in different areas caused from the surgery.

Any insight or advice or thoughts are very welcome

Have you read on our MS forum to see if it matches with your symptoms?

All of your concerns are valid. If your surgeon does not seem to be adequately working up your complications, then go outside the group for a second opinion.

Hi All,
thank you for your replies, I really appreciate it so very much.

Well, I saw my Ortho surgeon yesterday to get all the results of all the other specialists he sent me to, tests that were done & the MRI's I've had.
One of them is good news, the rest is not, so, the situations goes on further....

I was sent to a Gastro for bowel incontinence, he determined I have nerve damage.

I saw a Urologist which had me do a ultrasound-renal & my kidney's are fine, no issues there & this was the only good report I've had so far, the only one & I can't tell you how happy I was to hear that, it is one of the most important tests. He did a urine test & it showed white blood cells so it was sent out for a culture. It came back negative but, leaves me wondering why there are white blood cells in my urine?? He also had me do a urodynamic test & she explained Everything she was doing as well as watching the testing on the computer. She said my bladder would not stop jumping around and she could only get a small amount of fluid into my bladder because the pressure was so high. She also said that my urine flow coming out was not right, it's basically a dribbling flow. Then her end result was, she said that I have nerve damage. I have a problem with light urine leakage sometimes.
There is another test that the urologist will do on Sept 17th, a cystoscopy and will combine this test with the results from the urodynamic and I'll have the results that day.

Finally, he sent me to a Neurologist. She was the one who sent me for the brain MRI. During that visit she went over the MRI's I already had done, Cervical, Thoracic & lumbar, she said she was very concerned with my neck & C3-4 bulging right above where I was fused and it's pressing mildly on the spinal cord. She said she was going to call my Ortho surgeon to discuss it. (She never called him he told me). Then she sent me to a speech pathologist for the swallowing problems I have. I saw her this past Monday, 2 days ago & she wants me to get a modified barium test which is done by a radiologist. I have to schedule that. She did a physical exam also and is concerned about my "brisk" reflexes in my legs (My Ortho had mentioned this to me before) and arms.

So, my Ortho surgeon says this; his most concern was the MRI of my thoracic, there's a dorsal mass effect on the thoracic cord at T6 secondary to a oval cystic structure 2.2mm in length and 7mm diameter. There is also loss of volume of the thoracic cord at this level.
Then Additionally there is a component of ventral impression on the thoracic cord at the T6-T7 level secondary to a right paracentral disc protrusion.

He referred me to a Neurosurgeon because he does not specialize in cysts (tumors) that's on my thoracic so I have to make that appointment. He said he thinks my pains, numbness's, tingling etc. are coming from the thoracic issues, about from my breast area & down.
Also he doesn't specialize in the Brain & wants the Neurosurgeon to go over that MRI with me.

He said my neck, he could do the surgery on. He'd take the existing plate out & fuse C3-4 (disc herniation pressing on spinal cord), then there is stenosis at C5 and C5-6 (prior fusion was suppose to fix that!) and C6-7 there is small central disc protrusion and annular disc osteophyte complex. He'd fuse this level too.
Funny, back when I had ACDF surgery I got a 2nd opinion from a Ortho & he suggested doing all 4 levels but, the Neuro who did the surgery talked me into doing only 2 levels because he was concerned about the loss of range of motion and said I may or may not ever need another surgery! I should have listened to the Ortho & did all 4, now I am facing another neck surgery!

My lumbar MRI he said looks good. I asked if it's possible there are some nerves tangled up or some compressions after doing that surgery & the MRI doesn't show nerves so what test will? He said a CT scan but thought it's all coming from the thoracic again and wants me to see the Neurosurgeon first.

I think that covers my results up to now. I'm sorry that this is such a long post. I am so overwhelmed right now & wish I could crawl in a hole & die.
I am NOT suicidal, I am just so depressed over all of this and my brain is spinning out of control. All of this has been sooooo complicated!
I feel so lost and alone. I don't have a support system. No one understands my pain or my issues and all of this makes me feel sooooo sad and makes me cry.

Thank you for reading this & if anyone has any advice they could give me or has any questions, Please let me know.

Your thoracic concern sounds like it is the most prominent. Listen to your docs and pursue what is labeled your most immediate concern. Continue to work up everything else, but go after the immediate issues. Hang in there and keep your chin up!

sick & tired of just going on & on with tests and doctors.
I wish I could just get a diagnosis of what's wrong with me and move on to a treatment plan but it seems this doesn't stop. They find one thing after another that's wrong and no end result. How the heck does something like this happen to a person?

I can't keep this up, it's so depressing.