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"Can you help me interpret my MRI report?"
I am a 27 year old male currently experiencing symptoms of heavy headness, occasional numbness (especially in my left arm), left shoulder sourness, occasional problems with balance (especially while standing still). More recently, I can see lights and floaters in my vision, even with my eyes closed. I feared the worst in that I thought I had MS. My MRI came back "unremarkable" but that obviously does not make my symptoms go away. Can you help me interpret my MRI report in more layman's terms and enlighten me on what might be causing my problems? Here is the report verbatim. "Technique: Sagittal and axial T1 weighted images, sagittal and axial FLAIR images, axial T2 weighted images, axial gradient echo images and axial diffusion weighted images of the brain were obtained. Following gadolinum administration a volumetric T1 weighted gradient echo 3D data set was obtained; image post processing was employed to reformat this data set in additional imaging planes for review. Findings: The brain demonstrates no abnormal signal intensity. No white matter pathology is evident. No callosal pericallosal white matter lesion is seen. No cerebral cortical lesion is identified. There is no evidence of effusion restriction. Following gadolinium administration no abnormal enhancement occurs. No acute cerebral cortical infarct is found. No intracranial hemorrhage is recognized. No mass effect is found in the brain. The ventricles, sulci, and basal cisterns appear unremarkable. The vertebral and internal carotid arteries demonstrate expected flow voids indicating their patency. The left antorior cerebral artery A1 segment appears dominant. The orbits are unremarkable. The paranasal sinuses are significant for mucus retention cyst at the floor of the right maxillary sinus. The nasal septum deviates left to right. The nasopharynx is symmetric. The central skull base is intact. The temporal bones demonstrate patent petrous air cells. The calvarium appears unremarkable. Impression: Unremarkable MR of the brain. No white matter pathology is present to suggest demyelination. No abnormal enhancement." My primary care physican suspects two separate issues. 1. That my sinuses are congested and causing my feeling of heavy headness and 2. My back/shoulder/neck muscles are too tense and is causing my numbness. She put me on a muscle relaxers and something for my sinuses and will be going from there for the next week. Can my issues still be neurological even though my MRI came out unremarkable? Do you think my primary care physician is on the right track? I am just so frustrated and tired of feeling this way at this point and would appreciate any help out there.
Before going over the entire MRI report, we should start by saying that the MRI report is normal, which means that there are no abnormalities that are visible at the time of the MRI. That is not to say that there may not be other pathologies either intracranially, or in other parts of your body that may explain your symptoms or other disease processes that would not show up on an MRI of the brain. For instance, some of the symptoms in your arms and gait problems may be associated with something going on in your spinal cord, especially at the level of your cervical spine (i.e. herniated discs in your neck could give you many of the same complaints). It is best that you discuss these concerns with your primary care doctor who may decide to perform further tests, including imaging studies such as an MRI of the cervical spine. They may decide to refer you to a specialist such as a neurologist or neurosurgeon depending on what they find. A complete description of what was not found on your MRI report is beyond the scope of this discussion, but some of the main points are that there were no plaques noted that would be consistent with MS, there were no masses noted that may be seen when given with contrast, and no strokes or other acute changes.
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