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  • MRI findings

    Little background i went to my neuro for a 6 month checkup left eye was not tracking correctly as it was before so she ordered MRI to be done as precautionary. She called with these results on wednesday morning and is scheduling a lumbar puncture under sedation ASAP. she has told me to call her office immediately if i have any vision changes. I have advised her i get frequent pressure headaches, nothing severe but i know they are there type of thing. more annoying than anything else. eyes hurt when tired. i guess i am at a loss as to what is happening now. any one with any ideas? i know i will most likely need a neurosurgeon to follow now and possible surgery but i am just worried. I am currently a T6 incomplete para also.


    MRI Brain with & without Contrast
    ***Final Report***
    DATE OF EXAM: Dec 3 2019
    MRI BRAIN W and W/O CON (Acc#:7412465):
    EXAMINATION: Brain MRI without and with
    HISTORY: New left cranial nerve VI palsy. Comment. Past medical history
    with a question of multiple sclerosis in the past (never definitively
    diagnosed). Question of spinal cord infarct with resulting paraplegia.
    Baseline right eccentric osteopenia now with the left lateral rectus
    palsy without signs of optic neuritis.
    TECHNIQUE: An MS protocol MRI of the brain and internal auditory canals
    was performed both before and after the administration of intravenous
    contrast, as per the standard department protocol.
    Contrast: 10 mL of Gadavist
    COMPARISON: Head MRI dated May 14, 2015.
    FINDINGS:
    BRAIN MRI:
    There are few nonspecific FLAIR hyperintensities within the left corona
    radiata again noted.
    The ventricles, sulci and cisterns are age-appropriate. There is no
    mass-effect, midline shift, or space-occupying lesion. There is no
    abnormal enhancement.
    There is no hemorrhage or extra-axial fluid collection. There are
    scattered susceptibility foci again noted noted within the right frontal,
    left temporal, and right parietal lobes.
    There is no decreased diffusion to indicate an acute infarct.
    The principal intracranial flow voids are present.
    There is a partially empty sella again noted.
    There is mild prominence of the CSF space surrounding the optic nerves.
    The orbits are otherwise unremarkable. The left eye is deviated medially
    and compatible with history of left lateral rectus muscle palsy. There
    are bilateral staphylomas.
    The visualized paranasal sinuses and mastoid air cells are clear.
    IAC MRI:
    There is no abnormal signal within the brainstem specifically at the
    pontomedullary junction. There is no abnormal enhancement along the
    expected course of cranial nerve VI. The cavernous sinuses are normal in
    appearance.
    Cerebellopontine angles, internal auditory canals and inner ear
    structures are unremarkable.
    IMPRESSION:
    Medial deviation of the left eye compatible with the history of left
    lateral rectus palsy. No abnormal enhancement identified along the
    expected course of cranial nerve VI bilaterally. Also, there is no signal
    abnormality within the brainstem identified.
    No acute/subacute infarct, hemorrhage, mass effect or abnormal
    enhancement.
    Redemonstration of a partially empty sella as well as mild prominence of
    the CSF surrounding the optic nerves. Findings could reflect idiopathic
    intracranial hypertension in the appropriate clinical setting.
    Unchanged few scattered non-specific FLAIR hyperintensities in the left
    corona radiata. Differential is broad and would include sequela of prior
    infection/inflammation, sequela of chronic microangiopathy, or
    vasculitis, amongst many others. Pattern not typical for demyelinating
    disease.
    Redemonstration of multiple susceptibility foci as detailed above likely
    reflecting chronic microbleeds.
    T6 Incomplete due to a Spinal cord infarction July 2009

  • #2
    no I don/t but we are putting you on our prayer circle

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    • #3
      thank you forgot to add my neuro is most concerned with the increase of CSF around the optic nerves.
      T6 Incomplete due to a Spinal cord infarction July 2009

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      • #4
        I'm going tomorrow to see my neuro-ophmalogist.
        3 years ago I was in a store and suddenly the lower half of my right eye's field of vision went totally black. It was terrifying. I really don't know how long it lasted, probably less than a full minute but it seemed forever!
        After huge bank of tests, they think it was a blood clot in the retina.
        I've been on low dose aspirin ever since.
        69yo male T12 complete since 1995
        NW NJ

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        • #5
          i have an appt dec 23 with a neuro ophmalogist and a spinal tap tomorrow afternoon under sedation, i can only hope these headaches either go away or get better. so far no vision changes, just constant headaches and lately i have been getting a weird feeling when laying down like dizzy, lightheaded type feeling. should probably call my neuro about it but haven't yet.
          T6 Incomplete due to a Spinal cord infarction July 2009

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          • #6
            Originally posted by Smashms View Post
            i have an appt dec 23 with a neuro ophmalogist and a spinal tap tomorrow afternoon under sedation, i can only hope these headaches either go away or get better. so far no vision changes, just constant headaches and lately i have been getting a weird feeling when laying down like dizzy, lightheaded type feeling. should probably call my neuro about it but haven't yet.
            Smash, you've been on my mind and I was hoping someone with medical expertise would see this thread - all I know about increased CSF around the optic nerve is that it represents heightened intracranial pressure, but the cause could be any number of things. I'm glad you have an appointment with a neuro-ophthalmologist, and that a lumbar puncture will be done tomorrow. I've had spinal headaches and they are no picnic. It's a good sign that you haven't had vision changes. I hope a correct diagnosis won't be far off..
            MS with cervical and thoracic cord lesions

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            • #7
              well i had the LP today opening pressure was 26 which according to them is pretty high. my discharge diagnosis is idiopathic intercranial hypertension. i am sure i will receive a phone call in the morning from my neuro with the next steps. for now the headache is almost gone. thank god.
              T6 Incomplete due to a Spinal cord infarction July 2009

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              • #8
                Maybe the puncture relieved the pressure a bit. Hope you can get a good night's sleep, now that the headache is better.
                MS with cervical and thoracic cord lesions

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                • #9
                  well no call from neuro as of yet, i did just email her so she may call when she is done with clinic today or may wait till she gets the full result from them sometime next week. the headache came back around 11am today and i woke up in pretty severe back pain which i expected. hopefully she will call within the next day or so.
                  T6 Incomplete due to a Spinal cord infarction July 2009

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                  • #10
                    Ugh, I know you're not looking forward to going through another long diagnostic process - so I hope she calls you back today and gets you scheduled for exactly the right tests to rule things in or out.
                    MS with cervical and thoracic cord lesions

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                    • #11
                      Did they drain some spinal fluid off to bring the pressure down? They'll probably put you on diuretics to help get rid of the extra fluid. Watch your salt intake...less is better. Dizziness is something that goes along with IIH, ringing in your ears is another one. The vision changes is the biggest thing to watch for...double vision and/or temporary gray out's are things to watch out for and report to your docs if they happen. Your neuro-opth will do some visual field tests..if you drive, blind spots can get bigger with IIH...something to be aware of. They'll probably treat things medically for now...if vision issues crop up down the road, putting in a shunt is something that will help. IIH use to be a rare disease, don't know if it's till the case, you sure do hear alot more about it these days, compared to 40 yrs ago. There is some research being done by the Intracranial hypertension research foundation. https://ihrfoundation.org/ (couldn't get the link to work from here, arg) has more info.

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                      • #12
                        they did drain some out i think he said he drained around 20 out. diuretics i can't take because i am always fluid negative so if i take them no matter how much water i drink i get severely dehydrated very quickly. thanks for the link i will check it out. as i said opening pressure was 26 which my cousin said was pretty high she is a nurse so i was talking to her last night. just heard from neurologist who confirmed the opening pressure and discharge diagnosis of intercranial hypertension she is still waiting on the bloodwork to come back to rule out other things but she suspects to start me on some medication next week sometime.
                        Last edited by Smashms; 12-13-2019, 05:42 PM.
                        T6 Incomplete due to a Spinal cord infarction July 2009

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