10 Foci Bilaterally in Frontal Lobes

[Mommy5kids]

So I had my MRI follow up yesterday and the result said, "There are about 10 foci of increased T2 signal intensity in the frontal white matter bilaterally. These are nonspecific. While most commonly associated with chronic small vessel ischemic disease, other etiologies should be considered given the age of this patient (40). Some infections, vasculitides and demyelinating disorders can have this appearance. There is also an association with such foci and migraine headaches." (I've never had a migraine that I've known of).

Waiting on a neurologist appointment.

Any thoughts?

[jimmylegs]

google scholar says:

Mild cognitive impairment in stroke patients with ischemic cerebral small-vessel disease: a forerunner of vascular dementia?
http://www.tandfonline.com/doi/abs/10.1586/ern.09.73
Ischemic cerebral small-vessel disease accounts for a third of acute cerebral ischemic events and contributes to the development of cognitive decline and dementia. Cerebral small-vessel disease can be visualized on MRI studies as lacunar infarcts, white matter lesions and cerebral microbleeds. ...

Prevention and Management of Cerebral Small Vessel Disease
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4460330/
Lacunar infarcts/lacunes, white matter hyperintensities (WMH), and cerebral microbleeds (CMBs) are considered various manifestations of cerebral small vessel disease (SVD). Since the exact mechanisms of these manifestations differ, their associated risk factors differ. High blood pressure is the most consistent risk factor for all of these manifestations. However, a "J curve" phenomenon in terms of blood pressure probably exists for WMH. The association between cholesterol levels and lacunar infarcts/lacunes or WMH was less consistent and sometimes conflicting; a low cholesterol level probably increases the risk of CMBs. Homocysteinemia appears to be associated with WMH. It is noteworthy that the risk factors profile may also differ between different lacunar patterns and CMBs located at different parts of the brain. ...

mention of homocysteinemia and low cholesterol makes me curious about that b12 level again.

[Snoopy]

Hi Mommy5kids,

In a previous post you said you had a severe headache, this could have been a migraine. Migraines/headaches can cause lesions (foci) on MRI. Migraines can cause auras, neurological type symptoms and some are even silent.

hope your Neurology appointment goes well.