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pre-existing brain damage vs MS damage

Posted: Thu Nov 10, 2011 9:20 am
by laura85
I have a question I can't seem to find the answer to. If someone has pre-existing brain damage, will the MS scarring show up as easily or would you have to wait for the MS scarring to reach a part of the brain that isn't already damaged?

I ask because I have been having a lot of problems that keep directing me back to MS (which I do have a family history for), however, I have brain damage from losing oxygen at birth, which is somewhat extensive in parts of my brain.

So I'm curious if that damage would cover up any preliminary MS scaring or if there would be a way to tell if the already damaged portions were having more damage done to them on a brain scan. I asked some of my doctors but they kind of ignored the question like some doctors do.

Re: pre-existing brain damage vs MS damage

Posted: Sat Nov 12, 2011 1:04 pm
by gainsbourg
Have you had an MRI scan? These days it is the main diagnostic test for multiple sclerosis.

Re: pre-existing brain damage vs MS damage

Posted: Sat Nov 12, 2011 1:16 pm
by jimmylegs
i *think* when you get scanned with contrast dye, that active lesions show up better against a scarred background.

also the damage from hypoxia could be distributed differently compared to typical ms distribution ie corpus callosum, "dawson's fingers" http://en.wikipedia.org/wiki/Dawson's_fingers

Hypoxic cerebral lesions. X-ray computed tomography and MRI aspects. Apropos of 20 cases. Selective vulnerability of the striatopallidum
http://www.ncbi.nlm.nih.gov/pubmed/7629573

Regional axonal loss in the corpus callosum correlates with cerebral white matter lesion volume and distribution in multiple sclerosis
http://brain.oxfordjournals.org/content ... 1845.short

Re: pre-existing brain damage vs MS damage

Posted: Sat Nov 12, 2011 4:01 pm
by CureOrBust
No doctor here, however my two cents of understanding are:

1. An MRI for MS performs "slices" so they can see through the skull, and other non metallic water bearing materials, so they should be able to see the scarring differentiated from other brain goo (ie matter)
2. For MS, they are looking for inflammation, which is identified by a higher concentration of water (I think the contrast die highlights these regions) So, maybe they may not be able to distinguish old MS lesions from other damage :?
3. I am going to make a stabbing guess that your other previous non MS lesions are not experiencing current inflammation, so, at least the contrast images would show currently active MS lesions.

But again, I am no doctor. Try contacting the actual Dr who overseas the MRI operators, and provides the report on the images. He/She should understand what an MRI can or can not do.

Re: pre-existing brain damage vs MS damage

Posted: Sat Nov 12, 2011 5:22 pm
by euphoniaa
laura85 wrote:I have a question I can't seem to find the answer to. If someone has pre-existing brain damage, will the MS scarring show up as easily or would you have to wait for the MS scarring to reach a part of the brain that isn't already damaged?

I ask because I have been having a lot of problems that keep directing me back to MS (which I do have a family history for), however, I have brain damage from losing oxygen at birth, which is somewhat extensive in parts of my brain.

So I'm curious if that damage would cover up any preliminary MS scaring or if there would be a way to tell if the already damaged portions were having more damage done to them on a brain scan. I asked some of my doctors but they kind of ignored the question like some doctors do.
Hi Laura,

I'm surprised that your doctors ignored your question, but definitely neuros or radiologists who are more familiar with reading MRIs should be able to answer them. I'll give you a little of what I know, however. Jimmy posted links to show how MS lesions (or scars) can often be distinguished from other lesions (or scars) on the brain. My radiologist reports have always pointed out that my lesions are typical of "demyelinating diseases such as MS" and not other issues like strokes or masses from tumors. There are ways to tell the different types of lesions.

In the case of MS, if they take the MRIs both before and after they inject you with gadolinium it will somehow make "active" lesions "enhanced" and show your MS is currently active. Most interesting in my case is that my brain is jammed full of lesions specific to MS, but none of the lesions have ever shown enhancement. Also, MS lesions can actually come and go rather quickly. Or they can hang around for years like my old ones.

Keep in mind that different neurological problems still share a lot of common symptoms, so it takes experts to pin them down to one (or more) specific causes. I'm going to add one of my favorite links to the Whole Brain Atlas. If you scroll around on it you can see how different types of brain problems present in different ways, and many links (like the MS one) will give you a time-lapse tour of lesions coming & going.
The Whole Brain Atlas: http://www.med.harvard.edu/aanlib/

Good luck!

Re: pre-existing brain damage vs MS damage

Posted: Tue Nov 15, 2011 3:09 am
by Filmmaker
euphonia, just wondering: if your brain is full of lesions, how bad are your symptoms? I mean do you think there s a direct cause and effect between number or size of lesions and ability to function?
Also, are your lesions all white, any black one? I think MS damage is mainly from black "holes" whcih I still do not understand how ther appear...how can a lesion go from white to black? i guess it's the same question as how does cancer appear? for e.g coughing white mucus for a smoker is ok, but coughing black may indicate lung cancer... I guess it's the same with brain lesions, their color predicts the outcome... I wish I was a researcher:-)

Re: pre-existing brain damage vs MS damage

Posted: Tue Nov 15, 2011 4:36 am
by euphoniaa
Filmmaker wrote:euphonia, just wondering: if your brain is full of lesions, how bad are your symptoms? I mean do you think there s a direct cause and effect between number or size of lesions and ability to function?
Also, are your lesions all white, any black one? I think MS damage is mainly from black "holes" whcih I still do not understand how ther appear...how can a lesion go from white to black? i guess it's the same question as how does cancer appear? for e.g coughing white mucus for a smoker is ok, but coughing black may indicate lung cancer... I guess it's the same with brain lesions, their color predicts the outcome... I wish I was a researcher:-)
Hi Filmmaker (and Laura, and anyone else), I post the link to my thread with pictures of my brain lesions often :smile: , so here it is again: http://www.thisisms.com/forum/general-d ... 16335.html


No one has ever, ever mentioned lesion colors to me. :smile: But only that at least one of mine is BIG (tumefactive, to be exact). MRIs do not show in color, lesions are not actually "white", and I think that "black hole" may just be a reference to a type of lesion - or a serious worsening of one. I tried quickly to find a good explanation of it, but no time right now. Don't know, don't care, and my docs don't bother to discuss the details of my lesions, because what matters is how I'm doing, and I'm doing okay. :smile:

I actually got a diagnosis by accident with no serious complaints to my docs at all. When I mentioned to my GP at a regular checkup that I seemed to have a tiny tremor in one finger only when I reached for my alarm clock in the morning, he sent me to a physiatrist to check for carpal tunnel. EMGs showed I did have carpal tunnel, and that meant HNPP. He also noticed a slight difference in my reflexes on my right vs. left side, sent me for an MRI of brain & C-spine (with NO gadolinium contrast), and got an immediate dx of MS the next day.

My brain was full of lesions (at least 30 years worth). Lucky for me, MS brain lesions do NOT necessarily correlate to symptoms, exacerbations, progression, or anything else, because at that point I was feeling as healthy as I had ever been in my life. (I credit diet, exercise, sleep, music, humor.) Turns out the brain is very 'plastic' and resilient. I still work full time and I'm taking college classes.

Wishing us all the healthiest and most resilient 'brain damage' possible. :smile: And I'm sorry for hijacking the thread!

P.S. Feel free to correct my comments if I'm wrong.

Re: pre-existing brain damage vs MS damage

Posted: Tue Nov 15, 2011 4:49 am
by NHE
Filmmaker wrote:Also, are your lesions all white, any black one? I think MS damage is mainly from black "holes" whcih I still do not understand how ther appear...how can a lesion go from white to black? i guess it's the same question as how does cancer appear? for e.g coughing white mucus for a smoker is ok, but coughing black may indicate lung cancer... I guess it's the same with brain lesions, their color predicts the outcome... I wish I was a researcher:-)
MRI uses an electromagnetic pulse (EMP) and then measures the return energy from protons in the body's tissues. In a T1 image, the return energy is sampled 20 ms after the initial EMP and water appears black. In a T2 image, the return energy is sampled 200 ms after the EMP and water appears white. Gadolinium also enhances the imaging lighting up areas where there is active inflammation by indicating where the blood brain barrier is leaky due to immune cells crossing it.


NHE

Re: pre-existing brain damage vs MS damage

Posted: Wed Nov 16, 2011 10:08 am
by Filmmaker
Thx a lot euphonia and NHE. I meant by "black lesions" iron deposits which seems to be correlative with sx... but what do i know... still trying to understand!!
Euphonia, I admire your humour!! keep laughing:-)

Re: pre-existing brain damage vs MS damage

Posted: Wed Nov 16, 2011 12:12 pm
by euphoniaa
Filmmaker wrote:Thx a lot euphonia and NHE. I meant by "black lesions" iron deposits which seems to be correlative with sx... but what do i know... still trying to understand!!
Hmmm...well, I couldn't find the term "black lesions" anywhere, either at TIMS or quickly on a Google search. But if you're actually talking specifically about "iron deposits", which is an entirely different thing :smile: , plug the term into a "search" at the top of the screen. I got 33 pages of posts about them. Or check the CCSVI Forum.

Good luck.

Re: pre-existing brain damage vs MS damage

Posted: Thu Nov 17, 2011 1:59 am
by NHE
Filmmaker wrote:Thx a lot euphonia and NHE. I meant by "black lesions" iron deposits which seems to be correlative with sx... but what do i know... still trying to understand!!
Euphonia, I admire your humour!! keep laughing:-)
By black lesions, I thought that you might have been referring to black holes. Here's an image from BNAC which shows iron deposits using Dr. Haacke's SWI-MRI scanning procedure.

http://www.bnac.net/wp-content/uploads/ ... _image.jpg

NHE