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MRI Results

Alzheimer's, cardiovascular, and other chronic diseases; biomarkers, lifestyle, supplements, drugs, and health care.
Surupe
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MRI Results

Postby Surupe » Sat Jul 04, 2020 1:57 pm

Hi there!
I was hoping somebody with a medical background could help me interpret my neurologists report. I had a brain MRI last week and won’t be able to see her for a few weeks. I’m freaking out a bit based on her impressions. I’ve attached the report to this post as it’s difficult to type the whole thing. Thanks so much!!
Suzanne
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NF52
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Re: MRI Results

Postby NF52 » Sat Jul 04, 2020 3:01 pm

Surupe wrote:Hi there!
I was hoping somebody with a medical background could help me interpret my neurologists report. I had a brain MRI last week and won’t be able to see her for a few weeks. I’m freaking out a bit based on her impressions. I’ve attached the report to this post as it’s difficult to type the whole thing. Thanks so much!!
Suzanne
Happy 4th of July Surupe!

I hope my special educator friend has been able to put aside IEPs and enjoy more sleep as a silver lining of the last several months of schools being closed. As you know from past posts, I do not have any right to comment on an MRI report--but I do know what it's like to wait weeks for results, and have had friends waiting for neurologists to explain troubling phrases.

Here's my advice: I see a lot of good news on the report (no tumors, no strokes, no sinus problems, no history of skull fractures, normal blood vessel flow) and note of some small white matter hyperintensities. I asked a neurologist friend about this two years ago when someone told me she was concerned over an MRI that showed she had some and his response was "everyone has some of these as they get older--I have a friend with 80 and she's still doing research!" So while it might be something that the neurologist will want to address, from what I understand it is likely NOT related to Alzheimer's, but rather to your known family history of vascular illness. Since you've been such a standout athlete and are addressing all your varied dietary needs, your neurologist may say "well that's interesting, but not very predictive and here's what we're going to do about it." Remember: You're the same smart person you were before the MRI; it's only imaging; what researchers call a "biomarker". The more I sit on advisory panels, the more I realize that "biomarkers' are a lot like aptitude tests in school: interesting and sometimes helpful, but rarely telling us that only one path lies ahead. it always comes back to "But what is actually going on in your life?"

Hugs, Surupe!
4/4 and still an optimist!

Kathleen1
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Re: MRI Results

Postby Kathleen1 » Mon Jul 06, 2020 7:20 pm

I only have one on my MRI. I have a history of migraines, a family history full of early cardiac deaths,high lipids and a heart like a stone. You can see those white matter abnormalities with classic migraines, diabetes, hypertension, and sometimes lots of them without symptoms. Just like any other test, it is info to help you decide if you need to make any changes. NOT a deal breaker. Sometimes ladies who had eclampsia during pregnancy have a lot and in those cases the findings are longstanding, stable and not a worry. You can call that office again --your history makes a difference here-- and ask to at least talk to the doc given your appointment is so far out because it is ok to ask for reassurance. Note lots of folks on this site have small vessel ischemic disease and address the risks. Also coronary calcium scans may be useful in deciding about vascular risk--like whether to treat hyperlipidemia if you have the bad numbers. Hey no atrophy!! You win on that one. No dawson's fingers so no classic MS findings. Hang in there.

Surupe
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Re: MRI Results

Postby Surupe » Sat Aug 22, 2020 7:58 am

:| NF52 and Kathleen1,
Sorry this response is so delayed. I read your posts and they have given me great comfort.
At my appointment, the doc was not worried at all. First she said they were due to a mild concussion at age 14. She then changed her mind and said they were due to migraines. I have had only 1 migraine in my life. Then she said it was due to high cholesterol. With that, I decided to get another baseline of my cholesterol and go on statins. Guess what?? My ldl had dropped from 189 to 116. Triglycerides are 145 and total dropped from 275 to 202. Cardiologist said they were not caused by high cholesterol. Calcium score is zero. Carotid artery scan was completely clear. Blood pressure is normal as is glucose and A1C.
I’ve been doing lots of research and Apoe4/4’s have a higher incidence of WMH and on average, they increase 16% per year. If I don’t know the cause, how do I prevent them? Sadly, my executive functioning, ability to learn new things, and memory has dropped in the last few years.
I feel defeated since I do not know what to do.
E4/E4

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Julie G
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Re: MRI Results

Postby Julie G » Sun Aug 23, 2020 1:36 pm

I’ve been doing lots of research and Apoe4/4’s have a higher incidence of WMH and on average, they increase 16% per year. If I don’t know the cause, how do I prevent them?

Surupe, how’s your homocysteine? I ask as there’s a strong correlation between WMH and elevated homocysteine. Dr. Bredesen has set an ambitious goal of 7 umol or lower. If yours is elevated, there are specific supplements you can take to reduce it.

Surupe
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Re: MRI Results

Postby Surupe » Sun Aug 23, 2020 2:41 pm

Thanks, Julie G. It’s been awhile since I checked it. Maybe it’s time to check again. It was 6.8 a year and a half ago (down from 8.1). Good suggestion!
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Kathleen1
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Re: MRI Results

Postby Kathleen1 » Thu Aug 27, 2020 2:30 pm

You would benefit by getting a followup scan with and without contrast to compare to this one. I am not sure if the time interval would be 6 or 12 months, that would depend on your symptoms. You would be looking for changes over time that would suggest a diagnosis or a need for additional tests. A stable MRI and normal exams (including cognitive testing) would be reassuring. How long your scan has been like this is not known. A second study would give info. It is HIGHLY UNLIKELY that a mild concussion would give you the lesions described. If you had detailed neuropsych testing prior, whether or not it was normal, and there has been progression in your cognitive complaints, an additional neuropsych test might be useful. That might indicate a need for other studies--csf, nuclear scan.... Options also include getting a university level neuro opinion. Note with the white matter abnormalities, even if they are just the old, stable remnant of some prior insult,you may be a little more sensitive to the cognitive side effects of meds so review that issue with your doc. Take care. Your brain works and you know how to find out ways to keep yourself moving forward.

Surupe
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Re: MRI Results

Postby Surupe » Fri Aug 28, 2020 10:34 pm

Thank you for that response, Kathleen. I have some pretty serious text anxiety and I’m unsure about validity of results if I were to do a neuropsych eval. I lost my marbles when the doc asked me to draw a clock showing 10:50. I am a teacher and know how to tell time since I teach that concept quite regularly. But, I paced back and forth and got so wound up that I couldn’t even draw it until I calmed down. It was awful. I understand what you’re saying, though and I appreciate the suggestion. It may be time for a second opinion, too.
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Re: MRI Results

Postby Tincup » Sat Aug 29, 2020 6:58 am

Surupe wrote::| NF52 and Kathleen1,
I decided to get another baseline of my cholesterol and go on statins. Guess what?? My ldl had dropped from 189 to 116. Triglycerides are 145 and total dropped from 275 to 202. Calcium score is zero. Carotid artery scan was completely clear. Blood pressure is normal as is glucose and A1C.


I'm not a doc. However, with a CAC score of 0 and a clear carotid scan, I'd forgo the statin as there are a few reports of transient global amnesia from them . I would be concerned about the Trigs of 145. Fasting glucose and A1c aren't sensitive measures. The high trigs may indicate some insulin resistance (meds won't solve, only lifestyle). I'd be trying to get trigs in the 50-60 mg/dL range with HDL above that. Here is a section on it in the Primer.

I'd also read Stavia's recovery from a [urlhttps://www.apoe4.info/forums/viewtopic.php?f=4&t=647&p=5569&hilit=door#p5569]TBI[/url]. Exercise can stimulate BDNF which may be very helpful.
Tincup
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