Chapter 23 : Results of MRI tests

           Need to look at my results from my MRI tests.

MRI Results says possibly cavernomas or amyloid angiopathy.  This suggests both are equally likely. That there is a 50/50 chance of either occurring. This is a big mistake. It is much more likely that if you have two possibilities one is more likely than the other. What I need to know is the possibility I have CAA.

Being an uninformed and uneducated lay person I have gone to my friend Dr Google to try and help me. I have found the following. These are some possible guidelines for diagnosis of CAA associated with intracranial haemorrhage.

If the patient is older than 60 years and clinical and MRI data reveal a single lobar, cortical, or corticosubcortical hemorrhage without another cause; multiple hemorrhages with a possible, but not definite, cause; or some hemorrhage in an atypical location.

MRI may show evidence of multiple large and small, petechial cortical and subcortical hemorrhages, even in patients without a history of previous hemorrhage.

Punctate (usually < 5mm), round hypointensities, termed microbleeds, are frequently identified in white matter. Although these cerebral microhemorrhages are often present in amyloid angiopathy, they are not diagnostic of amyloid pathologically. Any conclusions regarding the significance of cerebral microbleeds must be interpreted given the individual patient or population being evaluated.

Microbleeds may be associated with hemorrhagic transformation of ischemic stroke. Microbleeds may be more common in patients with hypertension, but no characteristic pattern occurs in the distribution of microbleeds. Microbleeds may suggest a hemorrhage-prone angiopathy involving brain parenchyma distant from identified microbleeds.

MRI sequences show evidence of hemosiderin deposition that corresponds to old hemorrhages. In patients who present with lobar hemorrhages, evidence of old petechial bleeds can help in the diagnosis of cerebral amyloid angiopathy (CAA). Not an issue in my case. No old hemorrhages with hemosiderin formation.

How do these guidelines compare with my MRI results which are as follows?

Hyperdensity within right and left frontotemporal lobe.

Haemorrhage within right frontotemporal lobe.

Haemorrhage in left temporal lobe. May be subarachnoid or parenchymal.  Could be left superior frontal lobe as site of haemorrhage.

Multiple intracranial hemorrhages.

Looking at my results all the evidence suggests multiple intracranial hemorrhages of unknown aetioliolgy. All the evidence (including Dr Google) suggest that the best way to aid diagnosis is to have another MRI when better. I am now free of symptoms and booked for a new MRI in a few weeks. Can’t wait.