Congenital and acquired expansion of the subarachnoid space. Expansion of the subarachnoid space of the brain: what does it mean, treatment

The subarachnoid space is the distance between the soft and arachnoid membranes of the brain and. The second seems to “cover” its surface. On top it is protected by an additional layer of the endometrium, through which it communicates with other tissues using subarachnoid membranes. They are shaped like vessels and consist of several reservoirs where cerebrospinal fluid circulates.

In the subarachnoid space, the fluid is called cerebrospinal fluid, it is responsible for the following functions:

Nutrition and brain protection.
A medium for the exchange of useful substances that come from the blood and must enter the organ.
A channel of connection between nutrients and nerve cells.
Promotes the contractile activity of the heart, the functioning of the respiratory system, etc. Allows the human body to maintain the chosen position.

Norm and extension

What is the expansion of subarachnoid convexital spaces? This means that the norm is determined only when the amount of liquid is about 140 ml. If the interhemispheric fissure expands, a pathological condition occurs. The disease does not manifest itself in adults; it is typical for newly born children and older children.

Expansion of the subarachnoid space in an infant can be diagnosed due to injury during childbirth or the formation of abnormalities associated with brain development. This factor in the development of pathology occurs quite often.

In order to understand the nature of such an increase - moderate or significant, children are prescribed an ultrasound examination. This helps to find abnormalities and determine the condition of the subarachnoid convexital spaces.

The expansion comes in several degrees of severity:

light;
average;
heavy.

In the first degree, the expansion is small: maximum 1-2 mm (norm - 0). With a medium gap, the gap can reach 4 mm, and with a severe gap, it can go beyond this mark.

If you suspect an enlarged subarachnoid space in an infant, you should consult a neurosurgeon and neurologist. Usually, babies under one year of age are diagnosed with hydrocephalus. In this case, the interhemispheric fissure increases, which can be seen in the frontal lobes.

In this case, the ventricles of the brain have a moderate or slight expansion. Quite often they fully comply with the established norm. The cerebrospinal fluid inside the space is solid, as can be seen based on the results obtained through diagnostic measures.

Hydrocephalus can be benign or malignant. In the first case, it goes away by the second year of the child’s life. Uneven expansion of the space indicates that the cerebrospinal fluid is not distributed correctly in the cavities. Therefore, the gap between the ventricles increases and the pressure inside the skull increases.

If the subarachnoid space is expanded unevenly due to inflammation or tumors, then the cause of the disease is determined more quickly. They provoke pathological processes or infections, which are accompanied by inflammation and increased production of fluid inside the cavity.

Reasons for expansion

Detection of this pathology is aimed at identifying the reasons causing deviations from the norm in the amount of fluid. The main ones include:

The presence of infectious diseases affecting the central nervous system.
Formation of a small tumor in the cerebrospinal fluid or cavity.
Getting injured. or hematomas.
Inflammation of the sinuses.
Manifestation of intoxications that are chronic. Such substances that can cause such poisoning include: arsenic, alcohol, lead, derivatives of reactive inflammation that accompanies.

The disease is characterized by signs or development of hydrocephalus. Sometimes pathologies such as subarachnoiditis and leptomeningitis are diagnosed, in which the soft and arachnoid membranes of the brain become inflamed and the cavities are unevenly expanded.

Signs and diagnosis of pathology

If your baby shows signs of illness, you should not self-medicate. Symptoms for each child are individual, but only a specialist can create a general picture of the development of space expansion.

It was found that the most common manifestations of the disease are signs such as:

development of irritability to light and auditory factors;
presence of persistent headache;
dizziness, nausea and vomiting;
memory impairment (in adults);
increased drowsiness and fatigue;
large skull (in children).

At the beginning of its development, the disease may not manifest itself at all, so it is usually detected in the second or later stages. Symptoms arise directly depending on the type and type of skull deformation.

The severity of the pathology can be determined using traditional methods of examining the skull:

magnetic resonance imaging;
computed tomography;
neurosonography;
to prevent the formation of tumors;
ultrasound examination of the brain.

The results show what a tumor can be like in space, make it possible to see the layers of the brain structure, and trace the dynamics of tumor growth. Based on this, a decision is made regarding the use of one or another therapeutic technique.

Treatment is carried out by a neurologist, who may invite a neurosurgeon or other brain specialist for consultation. Therapy is aimed at, first of all, removing the cause of inflammation. As a result, the subarachnoid space should return to the parameters provided for by the norm.

First, the doctor prescribes medications that should fight infectious pathologies (sinusitis, otitis, etc.) that can lead to infection of the cavity in the brain. If there is increased pressure inside the skull, then special medications are prescribed to reduce it and normalize the condition.

The therapy is complex, it includes useful substances (vitamin B is the main one) and various antibacterial drugs. All medications are selected based on the individual characteristics of the patient.

Children under 3 years of age are usually prescribed the following medications:

Asparkam or Diarcarb to remove excess fluid in the skull;
Pantogam or its analogues to improve trophism of the brain and cerebrospinal fluid.

For older children or adults, treatment includes many more medications. These may be drugs that can relieve pain or spasms, as well as various types of barbiturates, saluretics, glucocorticosteroids, vasoactive substances and solutions containing plasma expanders.

Drug treatment is carried out simultaneously with a visit to the physiotherapy office. A set of special exercises is aimed at relieving symptoms, ensuring active metabolism in the body, and normalizing the nutrition of brain tissue. Usually, such methods - medications plus physical therapy - are enough to successfully fight the disease and make positive prognoses. In some cases, when medications are not effective, surgery may be performed.

The subarachnoid space is a cavity between the arachnoid and pia mater of the brain and spinal cord. This space is filled with cerebrospinal fluid or cerebrospinal fluid. The fluid is involved in protecting and nourishing the brain.

What is the subarachnoid space? The subarachnoid space contains up to one hundred and forty milliliters of cerebrospinal fluid, which flows from the brain through the openings in the fourth ventricle.
Its maximum is contained in the cisterns of space, which are located above the large fissures and grooves of the brain.

The subarachnoid space is divided by the dentate ligaments and the cervical septum, which fix it.

Reason for expansion of the subarachnoid space

Local expansions of the subarachnoid space are a signal of disturbances in the normal circulation of cerebrospinal fluid. This may be a consequence of injuries, tumors, or infectious diseases of the central nervous system. Undoubtedly, such a condition requires direct consultation with a neurologist or neurosurgeon and appropriate examinations.

The fact is that quite often the expansion of the subarachnoid space is a symptom of hydrocephalus or increased intracranial pressure.

The set of signs of external benign hydrocephalus in children of the first year of life is an increase in the subarachnoid spaces, which is most noticeable in the zone of the poles of the frontal lobes, while the ventricles of the brain can be only slightly dilated or have normal sizes. Moreover, the contents of these spaces have dense cerebrospinal fluid, which is observed on MRI, CT, and neurosonography. If it is benign hydrocephalus, then in most cases it resolves by two years of age.

Expansion of the subarachnoid space

The expansion of the subarachnoid spaces occurs in conjunction with an increase in head circumference and protrusion of the fontanelles, and a delay in the timing of their closure.

A noticeable expansion of the subarachnoid space may also indicate arachnoiditis or leptomeningitis, in which the soft and arachnoid membranes of the brain become inflamed. This may be the result of injury, infection, or a number of other influences. This pathology is detected using ultrasound.

The cause of arachnoiditis can also be chronic intoxication, for example, lead, alcohol, arsenic, reactive inflammation with slowly developing tumors and encephalitis.

General symptoms of arachnoiditis:

headache that is worse early in the morning, sometimes accompanied by nausea and vomiting,
dizziness,
general fatigue
irritability,
sleep disturbance.

The main thing in treatment is to eliminate the source of infection, for example, sinusitis or otitis media. For this purpose, antibiotics are prescribed in therapeutic doses.

Regarding the patient's life, the prognosis is usually favorable; only arachnoiditis of the posterior cranial fossa with occlusive hydrocephalus is dangerous.

Galina Mikhailovna asks:

The basal cisterns are moderately dilated.
The chiasmal area is without features; the pituitary tissue has a normal signal.
The subarachnoid convexital spaces and grooves are expanded, mainly in the area of the frontoparietal lobes and Sylvian fissures with moderately pronounced atrophic changes in the brain substance.
The midline structures are not displaced.
The cerebellar tonsils are located normally.
In the white matter of the left frontal and parietal lobes, foci of demyelination (2) measuring up to 0.5 and 0.6 cm, respectively, are detected.

Conclusion: MR picture of external replacement hydrocephalus. Focal changes in the brain substance of a discirculatory nature.
The patient is 62 years old and suffers from headaches in the crown area and noise in the right ear.

You can decipher the description, otherwise none of this is clear, is it worth seeing a doctor, is it serious. The doctor who made the description said that there was nothing wrong. Thank you very much in advance!

According to the examination, we can judge the changes in the brain typical for this age. However, if clinical symptoms are present, a personal examination by a neurologist is necessary.

Irina asks:

Hello!
I am 50 years old. I am very worried about headaches. I had an MRI of the brain. The picture shows moderate external replacement hydrocephalus. Multiple focal changes in the brain substance are probably of a discicular-dystrophic nature.
You can decipher the description, otherwise none of this is clear, is it worth seeing a doctor, is it serious. Thank you!

In this situation, you should definitely contact a neurologist for personal advice. Focal changes are most likely age-related. But signs of hydrocephalus indicate a violation of liquorodynamics, which is what causes headache attacks.

Elena asks:

I am 51 years old. I was admitted to the vascular department with a diagnosis of cerebral stroke. After treatment and discharge, I underwent an MRI examination of the brain, where it was determined that foci of demyelization were detected in the white matter of the frontal and parietal lobes, without signs of perifocal edema, most likely of dystrophic origin. Lateral ventricles of the brain. not expanded, with a moderately pronounced zone of gliosis along the periphery. The 3rd and 4th ventricles are unchanged, the basal cisterns are moderately dilated. The chiasmal area is without features, the pituitary tissue has the usual signal. The subarachnoid convexital spaces and grooves are unevenly expanded along the convexital surface of the brain and cerebellum, against a background of moderate cortical atrophy. The expansion of the perivascular liquor spaces of the penetrating vessels is determined, mainly at the level of the basal ganglia on both sides. The middle structures are not displaced. The cerebellar tonsils are located at the level of the cerebral cortex. Conclusion: a picture of external replacement hydrocephalus. Focal changes in the brain substance of a dystrophic nature. Question: probable causes and forecast for the future.

Specify your anthropological data, concomitant diseases and current condition. As well as the treatment received and the drugs currently used. Read more about stroke.

Elena comments:

Thanks for the answer! I’ll add: height 167, weight 80 kg. In childhood I suffered from rheumatism, pyelonephritis, until now I had vegetative-vascular dystonia of the hypotonic type 110/70, menopause since 2006, without any special features. She was admitted to the hospital after several attacks of hypertensive crisis with all the symptoms of an ischemic stroke ., after treatment with Actovegin IV, vitamin therapy, glycine, magnesia IM, was discharged under the supervision of a neurologist and further examination, continued treatment with indalamide, lisinopril, thromboasom, Sermion for a month, but dizziness, headaches, lack of coordination did not pass, I am currently undergoing treatment: IV Mexidol, vitamins and the same drugs in tablets, R-graphy of the cervical spine did not even reveal age-related changes, my health has improved, but only slightly. Stress, physical activity (except for gymnastics to remove fat deposits), alcohol consumption were not the cause of my health condition. I would like to know other probable reasons for preventing the recurrence of attacks and the prognosis. Maybe you should not pay attention, because the most important thing is that your arms and legs are working and your speech is not impaired, but I really don’t want to wait for attacks with more serious consequences. I am very grateful in advance for your answer.

Elena, the most important thing is to set yourself up so as not to live in anticipation of the next attack. You need to achieve weight loss, constantly monitor your blood pressure, and take antihypertensive medications. Be sure to monitor your blood cholesterol levels. It is necessary to consult a neurologist about a possible replacement of the diuretic. The prognosis in your situation is favorable.

Elena asks:

Hello, I'm 23 years old. I did an MRI of the brain. We made the following conclusion - the MR picture of external hydrocephalus. Single focal changes in the brain substance in the right frontal and right parietal lobes (dyscirculatory nature? demyelinating process?). Tell me, do I need treatment and is this diagnosis dangerous?

You need complex treatment under the supervision of a neurologist. In the absence of adequate treatment, damage to the central nervous system will progress leading to irreversible consequences. First of all, it is necessary to prescribe drugs that would normalize intracranial pressure.

Elena comments:

Please tell me, is intracranial pressure treatable and can it be caused by constant work at the computer in a sitting position?

Intracranial high pressure in some cases can be stabilized with medication. In any case, to determine the cause of increased intracranial pressure and prescribe adequate treatment, a personal consultation with a neurologist is necessary. Working at a computer for a long time can be one of the factors that increases blood pressure.

Elena asks:

I'll repeat it just in case. In September of this year, she was admitted by emergency medical service to the vascular center with a diagnosis of ischemic stroke, the diagnosis was made according to clinical data, although CT data for stroke were not received, after a course of treatment she was discharged with a diagnosis of ischemic stroke in the vertebrobasilar system. Cerebral atherosclerosis. Hypertension 3 risks4. IHD: atherosclerotic cardiosclerosis., for further treatment and observation by a neurologist. In October, she was admitted to the hospital with a repeated TIA, after treatment she underwent an MRI of the brain, which also did not confirm the stroke (in conclusion: a picture of external replacement hydrocephalus. Focal changes in the brain substance of a dystrophic nature). Discharged with a doctor: consequences of an ischemic stroke in vertebrobasilar region with left pyramidal week, severe ataxia, dysphagia, elements of dysarthria. Discircular encephalopathy 2 with severe cognitive decline. Cerebrovascular disease. I was sent to a commission to establish disability, where it was refused, citing the fact that there was no stroke, and the rest did not correspond, although I needed constant medication and observation by a neurologist. Currently, my health is not satisfactory (constant headaches, unsteadiness, I can’t do the lightest exercises, I can only move around the house). Question: did I have a stroke, as the doctors at the vascular center claimed? and is it worth applying again to establish disability, since you need to constantly purchase medicines, and there are financial difficulties, but you really don’t want to experience the humiliation of having to prove your poor state of health once again. According to my work book, I haven’t worked for 10 years (I worked part-time for a private owner , I can’t now). Thank you in advance for your answer.

Unfortunately, if the diagnosis of stroke is not confirmed by instrumental examination methods (MRI), it will not appear in the VKK documents. In the event that you want to apply for assignment of disability status again, you will need a thorough medical examination and consultation with a lawyer who deals with such problems, who will be able to advise you on legally valid possibilities for assigning this status in your particular case. You can read more about stroke, methods of diagnosis and treatment of this disease in our section: Stroke.

Ainura asks:

I want to know. What are you waiting for me? Thank you

Could you please clarify your question again? If you are sick, please clarify your full diagnosis to receive adequate advice.

Marina asks:

Hello, please help! My father is 47 years old, he has been bothered by headaches for a long time, he can’t hear at all in his right ear, there is numbness on the right side of his face. Sent for MRI, MRI showed - In the right - cerebellar angle, a solid space-occupying formation is determined, with clear, even contours, irregular rounded shape, dimensions 27 x 20 x 17 mm, heterogeneous hyperintense MR signal on T2 VI, isointense MR signal on T1 VI. In the white matter of the frontal and parietal lobes, irregularly shaped discicular lesions up to 4 mm are detected, without signs of perifocal reaction.
Tell me, how serious is this? what consequences? and what to do??? Thank you. Sincerely, Marina.

In this case, it is recommended to consult with an oncologist to conduct a personal examination, study the results obtained during the examination and decide on further treatment tactics and examination. If the above complaints are present at the moment, the situation is very serious, you cannot postpone a visit to the doctor, because any delay can only aggravate the situation and worsen the general condition. Read more about oncological examination by clicking on the link: Oncology.

Leah asks:

Hello! I have periodic severe headaches (several times a month). It starts with a headache, ends with vomiting, but there is no pressure. Recently I was vomiting all night with a temperature of 39. I donated blood, a swarm of 20, then 41. I did an MRI, changes only a slight expansion of the subarachnoid convexital spaces in the area of the frontal and parietal lobes. What kind of expansion is this? What to do? Where to look for the cause? Thank you!!!

Julia asks:

Hello, I was 30 years old and had an MRI examination because... I am bothered by frequent headaches. After the MRI, the conclusion “In the white matter of the frontal, parietal and left temporal lobes, small subcortical foci of increased signal intensity on T2 VI and FLAIR IP d up to 0.4 cm are detected. Please tell me what is this? And what could be the consequences?

An increase in signal intensity can occur for several reasons. It can be of inflammatory or vascular origin, and can also be determined even in the absence of pathology. It is not possible to make any conclusion based on the data you provided. First of all, you need to see the images directly, which should be evaluated in conjunction with other studies and your complaints. Only in this case will it be possible to talk about possible violations. It is also not possible to make a conclusion about the consequences, since they are assessed only after an accurate diagnosis has been established and adequate therapy has been carried out. In your case, I recommend consulting with a neurologist. Read more about diseases of the nervous and vascular systems and the causes of headaches in the section: Headache

Julia comments:

Conclusion The MR picture shows focal changes in the brain substance, most likely of a dyscyclic nature. I would like to understand this seriously???? So what's this??? and can these foci, for example, develop into cancer or a stroke???

Changes of a discirculatory nature do not lead to the development of brain tumors, and the cause of a stroke occurs in extremely rare cases. You need to be regularly monitored by a neurologist and receive appropriate treatment to restore normal microcirculation in the brain.

Tamara asks:

Tamara Leonidovna is 61 years old. Diabetes mellitus, grade 3 hypertension, grade 3 angina, asthma were diagnosed, 5 months ago a hypertensive crisis occurred, Bell's palsy occurred on August 14, and he was sent for an MRI. MRI conclusion: a picture of moderate phenomena of external replacement hydrocephalus. areas of gliotic changes in the left frontoparietal region and pons of the brain, of a post-ischemic nature. Focal changes in the brain substance, discirculatory in nature. MR signs of intraosseous formation in the right parietal bone. At the moment the improvements are minor, headaches, noise phobia, trimer, weakness. The face has straightened out a little but is far from normal. Sugar is on average 10-14mmg.

Nellie asks:

Hello! My mother is 51 years old. She often suffers from headaches, her blood pressure is normal. My mother did an MRI and here is the diagnosis: “MRI picture of multiple finely focal changes in the brain substance of a discirculatory nature, not pronounced mixed replacement hydrocephalus.” Please tell me whether this is a serious diagnosis? And what will happen? further? How can this diagnosis be treated. THANK YOU in advance!

In this case, if there are changes in the brain associated with hemodynamic disturbances or complaints, it is recommended to consult a neurologist to conduct a personal examination and assess the current condition, as well as prescribe adequate treatment. With timely treatment, the condition may improve and the changes will not progress. Read more about the causes of headaches in a series of articles by clicking on the link: Headaches.

Natalya asks:

My husband has a high pulse (120 - 140 beats) and is bothered by headaches. There are attacks - very strange, the neurologist sent me for an MRI and EEG. This is what is written in the MRI report - a picture of external, internal hydrocephalus. Expansion of a large tank. Single focal changes of vascular origin in the white matter of the cerebral hemispheres. Cyst-like dilatation of the cistern magna. The pain is very disturbing, but the neurologist prescribed only pills for epilepsy... And my head hurts! and what to do?? what to drink for pain and how to remove this fluid from the brain?? I read that diuretics, but which ones are possible? I'm desperate.........

According to the examination data provided, there are pronounced disorders: internal hydrocephalus, dilatation of the ventricles of the brain, impaired hemocirculation, and the presence of a cyst. In this case, it is necessary to undergo complex treatment; the prescription of antiepileptic drugs is justified, because all these changes can cause seizures. It is recommended to re-consult with a neurologist to decide whether hospitalization is necessary, to carry out complex treatment, or to prescribe adequate therapy on an outpatient basis. It is also recommended to consult with a cardiologist to prescribe adequate treatment, because pulse is much higher than normal. Read more about headaches in the section of the same name by following the link: Headache.

Ekaterina asks:

She did an MRI of the brain, angiography of the cerebral arteries. Conclusion: MR signs of expansion of the subarachnoid convexital and perivascular spaces. Single focal-dystrophic changes in the brain substance measuring 0.2-0.3 cm. Based on the MR picture, no data for pathological changes in the cerebral arteries were identified .Please tell me what this is? And is it dangerous?

If such changes occur, the blood supply to the brain may be impaired. You need a personal consultation with a neurologist to evaluate the result in combination with the clinical picture, complaints and anamnestic data. At the moment, there are no threatening or dangerous changes, but the selection of corrective treatment is required, which the treating neurologist can do for you. You can learn more about this study from the thematic section of our website: MRI

Lyudmila asks:

MR picture of focal changes in the brain substance of a discirculatory nature, moderately pronounced diffuse bihemispheric atrophy

According to the results of the examination, there are signs of atrophy of brain tissue; perhaps the atrophy is associated with cerebral circulatory insufficiency. To clarify the situation, a personal consultation with a neurologist is necessary. You can read more about deciphering MRI results in our section dedicated to this diagnostic method: MRI. You can read more about examining a neurologist and what questions you should ask this specialist in the section: Neurologist.

Varvara asks:

MRI showed focal changes in the white matter of the brain, apparently of a vascular nature. How dangerous is this and how can it be treated?

Nadya asks:

MRI picture of uneven expansion of the subarachnoid convexidal space. A single focus of gliosis of a discirculatory nature

Unfortunately, based on the examination results you provided, it is impossible to give a conclusion about the severity of the brain damage. You need a personal consultation with a neurologist to evaluate the results of the examination. You can read more about the examination of a neurologist and why it is needed in the section: Neurologist.

Nina asks:

MR picture of external replacement hydrocephalus, slightly pronounced. Single foci of demyelination in the brain substance of a dystrophic nature. what does it mean? Do I need to see a doctor? I am 45 years old.

In this case, you must be examined by a neurologist, since if you have replacement hydrocephalus, the doctor will be able to prescribe treatment for you depending on the data of the general examination, neurological status and existing complaints. You can learn more about this from the section: Hydrocephalus

Andrey asks:

MRI picture of post-traumatic, postoperative zones of cystic-gliotic changes in the right hemisphere of the brain and in the right hemisphere of the cerebellum. Internal non-occlusive and external hydrocephalus.

MRI revealed hydrocephalus (internal and external), as well as post-traumatic and postoperative changes. In this situation, it is necessary to consult a neurologist or neurosurgeon, a detailed study of the medical history and an assessment of the current neurological condition, which will allow you to select adequate treatment (drugs that reduce brain swelling, improve microcirculation). I recommend that you personally consult with your treating neurologist. You can learn more about hydrocephalus from the thematic section of our website: Hydrocephalus

Marina asks:

Please explain the diagnosis:

On a series of MR tomograms, weighted by T1 and T2 in three projections, sub- and supratentorial structures are visualized. The lateral ventricles of the brain are of normal size and configuration. The subarachnoid convexital space is locally unevenly expanded, mainly in the area of the frontal and parietal lobes. The midline structures are not displaced. In the white matter, in the area of the basal ganglia and semioval centers, expansion of the perivascular spaces of Virchow-Robin is determined. The cerebellar tonsils are located at the level of the foramen magnum. In the white matter of the frontal and parietal lobes, subcortically, single small foci of increased T2 and FLAIR signal are detected, without signs of a perifocal reaction, probably of a dystrophic nature. Conclusion: MR picture of a single expansion of the arachnoid spaces in the area of the frontal and parietal lobes. Single focal changes in the brain substance of a dystrophic nature. Thank you in advance.

Denis asks:

Volumetric and focal formations in the brain are not identified. The ventricles of the brain are not expanded, the lateral ventricles are symmetrical. The dimensions of the lateral ventricles (at the level of the foramen of Monroe): right 8 left 8 The middle structures are not displaced. Moderate uneven expansion of the external liquor spaces subconvexitally in the fronto-parietal regions, lateral fissures. The occipital cistern is reduced in volume, the cerebellar tonsils prolapse in the BZ up to 5 mm. The sellar, pineal region, cerebellopontine angles, craniospinal junction are usually visualized. The course and caliber of the great vessels - b\o Good afternoon, I am 30 years old recently I'm worried about burning and tingling in the head in different places, sometimes in the frontal area, then in the back of the head, then in the temples! Help me, tell me what’s wrong with me and how to treat it please!

Unfortunately, it is not possible to prescribe treatment for you solely on the basis of the provided research results in an online consultation. I recommend that you personally visit a neurologist who can compare the research protocols with your complaints and clinical examination data. Only after this will it be possible to establish a diagnosis and begin treatment. You can obtain more information on this issue in the corresponding thematic section of our website by clicking on the link: Computed tomography (CT)

Elena asks:

I am 36 years old. For 10 days now I have had a very bad headache in the lower right back, but I have never suffered from headaches before. I did an MRI, this is what they wrote - focal changes in the white matter of the frontal lobes, the genesis is questionable (foci of beliosis of a vascular nature? hemeelinating process?) moderate external hypotrophic hydrocephalus... it’s kind of scary. Please tell me what to do and what awaits me?

Elena comments:

Good afternoon, thank you for your participation! I underwent an additional examination, everything is fine with the eyes, the vessels of the neck are also normal, but the x-ray did not please me - osteochondrosis and uncovertebral arthrosis, instability. They prescribed Milgamma and physiotherapy, but the headache does not go away. Can osteochondrosis be the cause of focal changes?

Natalia asks:

Hello. I am 35 years old. It is not yet possible to contact a neurologist, so if possible, I would like to hear here an explanation and decoding of my conclusion, as well as possible consequences, preventive/treatment measures. MRI conclusion: “There is an expansion of the subarachnoid spaces around the penetrating vessels of the brain in the basal nuclear zones. In the area of the anterior horn of the left lateral ventricle, single foci of a dystrophic nature 1-3 mm in diameter are visualized. Initial discirculatory changes in the brain.” Everything else according to the scripture has not been changed. Thank you in advance!!!

These changes are age-related and moderate in nature. If there are clinical complaints, a personal examination by a neurologist is required. Treatment can be prescribed only after examination by a doctor, depending on the indications. You can get more information on this issue in the thematic section of our website: MRI

Natalia comments:

Thanks for the answer! Forgive me, did I understand correctly that the presence of such complaints as poor memory, absent-mindedness, inattention, mental lability and instability, a tendency to depression are not indications for contacting a neurologist? and can the above complaints affect the size and number of lesions in the future? and also, such foci of a dystrophic nature and dyscirculatory changes as mine are not yet indications for the use of some drugs, for example, those that improve blood supply to the brain?

In any case, if you have any complaints, you should personally visit a neurologist who can prescribe you adequate treatment. You can get more information on this issue in the thematic section of our website by clicking on the link: Neurologist and neuropathologist

FATINHA asks:

Hello! I am 22 years old. They did an MRI of the brain. Conclusion: A single change in the brain of a dystrophic nature. Tell me how this is treated? Is it dangerous at all? Could this be due to cervical osteochondrosis, there was an exacerbation recently.

A single change in the brain of a dystrophic nature, as a rule, is a consequence of impaired blood circulation and vascular patency. As therapeutic measures, drugs are prescribed that improve cerebral circulation, microcirculation, and strengthen blood vessels. This condition is not threatening, but requires correction, so I recommend that you personally visit your attending neurologist, who will be able to prescribe the appropriate treatment for you. You can get more information about this study in the thematic section of our website:

Lily asks:

Hello! I am 54 years old. I have frequent headaches on the right side of my head and face, and sometimes I feel numbness on the right side of my head. Nausea, dizziness and weakness. I did an MRI. Conclusion: Based on the MR image, no evidence of a space-occupying lesion in the brain was obtained. A single lesion in the left temporal lobe, probably of a dyscirculatory nature. Cystic thickening of the mucous membrane of the right maxillary sinus. Option for the development of the Circle of Willis. A marked decrease in the signal from the blood flow along the intracranial segment of the right VA (hypoplasia?). Areas of stenosis in the A2 segment of the left ACA and in the P1 segment of the right PCA cannot be excluded.
Please tell me how serious this is? Which specialist should I contact?
Thank you.

In this situation, your complaints are most likely related to cerebral circulation disorders. With adequate treatment, existing symptoms can be eliminated. I recommend that you personally visit a neurologist who will prescribe you appropriate drug treatment. Read more about this study in the section: MRI

Anna asks:

Hello!
My husband is 37 years old; he has been suffering from constant headaches for about 10 years, but his blood pressure is normal. I had a concussion in my youth. Examinations (several years ago) by a neurologist did not reveal anything; painkillers were prescribed. Lately my head has been hurting really bad. He did an MRI of the brain, according to the results: “Based on the MR picture, no data for focal and diffuse changes were obtained. Slight expansion of the main and quadrigeminal cisterns. Edema of the mucous membrane of the left upper quadrant, mastoid cavity on the left.” What might this conclusion indicate? What other necessary examinations need to be done to make a diagnosis? Thank you in advance!

These changes are possible in the presence of increased intracranial pressure, which may be a consequence of previous injuries. I recommend that you personally visit a neurologist who, based on the available results, as well as taking into account your medical history and clinical symptoms, will be able to prescribe adequate treatment for your spouse. You can get more information on this Question in the corresponding section of our website by clicking on the link: Magnetic resonance imaging (MRI). Read about the causes of headaches and their diagnosis in the information section of our website: Headache

Oksana asks:

Hello! I am 43 years old, I had an MRI of the brain, the conclusion was a picture of moderate dystopia of the cerebellar tonsils. Single focal changes of vascular origin in the white matter of the cerebral hemispheres. What does “focal changes in white matter” mean? I am periodically bothered by dizziness (when changing the position of the head, when bending down), pain in the back of the head.

Focal changes may indicate that the blood supply is impaired in certain areas, which requires drug treatment. Dizziness may be associated with dystopia of the cerebellar tonsils, since it is this organ that is responsible for the coordination of movement. I recommend that you personally visit a neurologist to prescribe adequate treatment. Read more about this study in the section of our website: MRI

Alena asks:

Help me decipher what is - Focal lesion of the left parietal lobe, Deterotopia of the gray matter? Are they recruited into the army with this diagnosis?

Marina asks:

Hello! My son is 18 years old, a psychiatrist diagnosed him with depersonalization, direalization, MRI conclusion: A single focus of dyscirculation in the left frontal lobe. Pineal gland cyst 11x8x6 mm. Intermediate velum cyst. Moderate open internal hydrocephalus of a replacement nature. Could these changes cause psychiatric illness?

Unfortunately, these changes can cause the development of psycho-neurological disorders. You need to personally consult with a neurosurgeon regarding further treatment tactics, and I also recommend that you visit a psychologist who can provide real assistance in correcting such manifestations. Read more about this in the section: Psychologist

Victoria asks:

Based on the MRI results, I received the following conclusion:
MR picture of uneven expansion of subarachnoid spaces. A single focus of demyelination in the right parietal lobe (probably dystrophic in nature). Tell me, is this something scary???? What to do?

Expansion of the suarachnoid space is often observed due to traumatic brain injury, increased intracranial pressure and previous infections of the central nervous system. Foci of demyelination are often found in diseases such as multiple sclerosis. In this case, it is necessary to personally study the images obtained, so I recommend that you visit a neurologist, who, after studying the study protocols, will be able to make a conclusion, establish the correct diagnosis and prescribe you the appropriate treatment. You can get more information on this issue in the section of our website: MRI

Galina asks:

I had an ischemic stroke twice (July 2008 and November 2011 - there are MRI study protocols). Today in July my legs gave out again and I felt weak again. I made an MRI report in November: an MRI picture of focal changes in the brain of a dystrophic and post-ischemic nature (previous lacunar infarctions). Mixed replacement hydrocephalus. Doctors send to a commission (VTEC). Is it worth it or not? (I have already been refused 2 times (after the first and now on October 1). Age: 60 years old, weight: 58 kg, height: 164.

In your situation, there are all indications for obtaining a disability group; the issue in this case is decided by a medical commission. I recommend that you prepare all the documents and visit the VTEK commission. You can get more information about your disease, its course and treatment in the thematic section of our website by clicking on the link: Stroke

Svetlana asks:

Hello. My 27-year-old husband began to suffer from severe headaches. We did an MRI: on a series of T1- and T2-weighted MRIs, sub- and supratentorial structures were visualized in three projections.
The lateral ventricles of the brain are of normal size and configuration. 3rd and 4th
the ventricles and basal cisterns are not changed. The chiasmal area is without features, the pituitary tissue has a normal signal.
The perivascular Virchow-Robin spaces are expanded, mainly in the area of the basal structures.
The roots of 8 pairs of the cranial nerves in the region of the cerebellopontine angle can be traced on both sides and are symmetrical.
The subarachnoid spaces are locally expanded along the convexital surface of the brain and in the area of the lateral fissures. The median structures are not displaced. The cerebellar tonsils are located normally.
In the white matter of the right parietal lobe, a rounded focus of gliosis is detected subcortically, measuring 0.5 x 0.4 cm, without a perifocal reaction.
The mucous membrane of the nasal turbinates is thickened, the nasal passages are narrowed, and patency is preserved. Deviation of the nasal septum to the right by 0.5 cm is determined.
Conclusion: MR picture of external replacement hydrocephalus. Focal changes in the brain substance of a residual nature. Curvature of the nasal septum.
Consultation with a neurologist, otolaryngologist.
The ENT specialist said that everything is fine. We live in the region and will not see a neurologist soon. I am very worried about what this is, how serious it is and whether it is curable.

According to this conclusion, there are signs of replacement hydrocephalus, which happens in such cases: increased intracranial pressure, changes in blood vessels and metabolism, encephalopathy, etc. Treatment in each case is prescribed by a neurologist based on a study of the medical history, research protocols, personal examination and patient complaints. There is no need to worry ahead of time, but try to get to a neurologist in a timely manner, who can prescribe adequate treatment. For more information on the issue you are interested in, you can find information in the thematic section of our website: Replacement hydrocephalus

Andrey asks:

MRI of the brain reveals residual focal changes in the left cerebral hemisphere.
MRI of cerebral vessels reveals a disruption of the intracranial section of the right vertebral artery.
Explain in simple words what is this? and is it treatable?

Residual changes is a term meaning residual effects of encephalopathy, that is, those changes that could have formed as a result of injuries, hypoxia, intoxication, etc. If you have any complaints, you must personally visit a neurologist for an examination and prescribe adequate treatment. You can find out more detailed information on this issue in the thematic section of our website by clicking on the following link: Magnetic resonance imaging

Vera asks:

In the white matter of the frontal and parietal lobes, numerous small foci of gliosis with unclear contours, without signs of perifocal edema, are identified subcortically and pereventicularly. What does this simply mean that there was a micro stroke before?

Foci of gliosis can be figuratively compared with scars that develop in the tissues of the central nervous system as a result of past diseases, in particular: encephalitis, tuberous and multiple sclerosis, hypoxia, chronic hypertensive encephalopathy, epilepsy, long-term hypertension, lipid metabolism disorders, etc. . This change does not indicate a micro-stroke. I recommend that you personally visit a neurologist to prescribe adequate treatment. You can get more detailed information on the issue you are interested in in the thematic section of our website by clicking on the following link: Neurologist and neuropathologist

Galina asks:

Hello..I am 46 years old. I recently had an MRI of the brain...because in the last month I have had two hypertensive crises. I have hypertension and I take medications. Biprol, indopamid and lisinopril.. Until recently there were no crises and I didn’t feel bad.. After the last attacks, my blood pressure dropped very significantly to 95 and frequent headaches began. The MRI findings are as follows: MRI picture of arachnoid changes of a liquorocystic nature. Focal changes in the white matter of the brain, of a dystrophic nature. Periventricular zones of gliotic changes.. Tell me what this means and whether I need to see a doctor.. Thank you..

Polina asks:

Hello! I am 20 years old.
The history of my illness is as follows: at the age of 4 I was diagnosed with epi syndrome, there were 3 attacks, after 5 years the diagnosis was removed. At the same age there were 2 traumatic brain injuries - strong blows to the back of the head.
At the age of 10, migraines began, and every year they became more frequent and severe. No painkiller pills help anymore.
Hypotension.
With a migraine, the right side of the head hurts, spasms radiate from the temple, the eye, cheekbone and jaw turn out. It makes me very sick. It hurts to walk and talk.
Sometimes there are very strong sharp and dull pains in the back of the head and to the left of the top of the head: a few blows and everything goes away.
Two months ago, pain began in the arms and legs: as if pressure points were being pressed on the elbows and knees, such sharp attacks of pain, and then weakness.
A few days ago I had an MRI and duplex study of the vessels of the neck. The doctor diagnosed: VSD and moderate angioencephalopathy.
I had doubts because some symptoms, such as seizures, are not explained by these diagnoses.
Here is what is written in the MRI: in the subcortical parts of the frontal lobes of both hemispheres, single foci of gliosis of a dystrophic nature are detected. There is an expansion of the perivascular spaces along the perforating vessels of the brain at the level of the basal ganglia at the supraventricular level.
In conclusion on the duplex: signs of slight extravasal influence of the V3 segment of the VA on the right with a slight difference.

Tell me, is it possible that the doctor made a mistake and I have something else or something besides this?

Unfortunately, it is possible that the previous convulsions were a manifestation of a convulsive syndrome, which could be a consequence of injuries. I also recommend that you do an EEG, which will allow you to judge the presence or absence of a tendency to develop a convulsive syndrome. You can find out more detailed information on this issue in the corresponding section of our website by clicking on the following link: EEG

Polina comments:

This is clear, thank you. What about gliosis foci? I read that a brain tumor - glioma - consists of gliosis. Could this develop from isolated outbreaks into something more serious?

Foci of gliosis and glioma are different concepts. Foci of gliosis represent the replacement of nervous tissue with neuroglial cells. Foci of gliosis appear as a result of hypoxia, encephalopathy, encephalitis, prolonged arterial hypertension, multiple sclerosis and many other diseases. In this case, treatment is carried out for the underlying disease. You can get more detailed information on the issue you are interested in in the corresponding section of our website by clicking on the following link: Computed tomography - the latest diagnostic method

Lyudmila asks:

Hello! I had an MRI done on me, 52 years old. In the white matter and subcortical parts of the frontal, temporal and parietal lobes, foci of gliosis measuring up to 0.4 cm are detected, without a perifocal reaction: please explain what this means? And the conclusion is MRI signs of focal changes in the brain substance, more likely, dystrophic in nature. MR signs of moderately expressed mixed replacement hydrocephalus! How to understand this, please explain, and is it worth raising a panic about this!!! or is it not scary!!!

These changes do not cause panic - they are age-related and could arise as a result of hypertension, atherosclerosis, traumatic brain injury, hypoxia, etc. In this situation, you need to routinely visit your attending neurologist, who, after an examination, a thorough examination of your medical history and evaluation of research results, will be able to prescribe you adequate treatment. You can obtain more detailed information on issues that interest you in the thematic sections of our website by clicking on the following links: Magnetic resonance imaging (MRI)

Marina asks:

Hello, I'm 20 years old. Here are the MRI results.
T2 weighted and FLAIR tomograms of the brain were obtained in the axial projection, FLAIR tomograms - in the frontal projection, T1 weighted - in the sagittal projection. No focal formations or pathological changes in the intensity of the MR signal were detected in the cerebral hemispheres, brainstem, or cerebellum. The midline structures are not displaced. The ventricular system is not deformed and is of normal size. The lateral ventricles are slightly asymmetrical (S>D). The cisternal spaces of the brain are usually expressed and symmetrical. Convexital subarachnoid grooves are expressed unevenly, the pattern of grooves in the cerebral hemispheres is enhanced. The subarachnoid space of the parietal lobes, left occipital lobe and right lateral fissure is slightly expanded. The pituitary gland is differentiated and not enlarged. Cerebellar tonsils on Chamberlain's line. The cerebellopontine angles are without additional space-occupying formations, the internal auditory canals are not dilated.
Tell me, is this serious and who should I contact for treatment?

These changes are not threatening and can be observed with intracranial hypertension, replacement hydrocephalus and other pathologies, so I recommend that you personally visit a neurologist to prescribe treatment. You can get more detailed information on the issue you are interested in in the corresponding section of our website by clicking on the following link: Computed tomography

Nikolai asks:

Conclusion: MRI picture of ischemic stroke in the basin of the terminal branches of the left cerebral, middle cerebral and partially anterior cerebral artery (acute-subacute stage) against the background of small-focal changes in the white matter of the occipital, parietal lobes of vascular origin from both sides.
Woman, 54 years old, 110/65 sugar and normal cholesterol. Prospects for recovery. Thank you.

The existing changes are quite serious and therefore require monitoring over time. You need to receive comprehensive treatment under the supervision of a neurologist, as well as continue monitoring, which will determine the prospects for recovery. You can get more detailed information on the issue you are interested in in the thematic section of our website by clicking on the following link: Stroke. You can get additional information about magnetic resonance imaging in the corresponding section of our website: Magnetic resonance imaging (MRI)

Lyudmila asks:

Hello, my son is 13 years old, in the last month he started having seizures, he had never had them before. We were sent for an MRI.
An MRI of the brain revealed no volumetric lesions. Supra, paraventricularly at the posterior horns, small single foci are detected, up to 2 mm in diameter, with a hyperintense MR signal in the T2w image. The subarachnoid spaces are moderately locally expanded over the surface of the brain. Sylvian fissures are not widened. The differentiation of gray and white matter of the brain is not impaired.
The basal cisterns of the brain (parasellar, interpeduncular, great cerebral vein, pontine) are not dilated.
The lateral ventricles are not dilated, symmetrical, at the level of the bodies on the right 8 mm, on the left 8 mm.
The third and fourth ventricles are not dilated.
The midline of the brain is not displaced.
The basal ganglia are unchanged.
Stem sections, area h.ch.ya. without features. The cerebellopontine angles are unchanged.
Sella turcica - location, shape, contours, dimensions are usually visualized. The pituitary gland, its infundibulum and epiphysis are located normally, the shape and dimensions are not changed.
The craniospinal junction is unchanged.
The eyeballs, retro-orbital tissues and optic nerves are unremarkable.
Paranasal sinuses - local swelling of the mucous membrane of the ethmoidal labyrinth on the right, mastoid processes, middle and inner ear is usually visualized.
No bone destructive changes were detected.
At the C1-C4 level in the spinal canal there are no pathological formations.
Please tell me how serious and dangerous this is for my son?

According to this conclusion, signs of intracranial hypertension cannot be excluded. To find out the nature of the seizures, I recommend that you do an EEG and personally consult with a neurologist. You can get more detailed information on the issue you are interested in in the thematic section of our website by clicking on the following link: EEG

Tatyana asks:

I am 39 years old and had an MRI without contrast.
Conclusion: MRI signs of calcification of the falx, a single vascular lesion in the parietal lobe on the left, expansion of the cerebrospinal fluid spaces.
I didn't understand a single word. What is this? The unknown is scary.

These changes in themselves do not constitute a diagnosis; they reflect visible changes that were identified as a result of a computed tomography scan. In this situation, intracranial hypertension and vascular changes cannot be ruled out, so you need to personally visit a neurologist for an examination, study of research protocols, comparison of existing results with clinical symptoms, etc., after which the attending physician will be able to establish the correct diagnosis and prescribe an adequate treatment. You can find out more detailed information on this issue in the thematic section of our website by clicking on the following link: Computed tomography (CT)

MARINA asks:

Hello! A 10-year-old son was diagnosed with focal heterotopia of the gray matter in the central part of the left lateral ventricle. Please tell me what is this?

Heterotopia of gray matter is not a diagnosis; this change characterizes a shift in the localization of gray matter in a certain area, which is a malformation of the brain. Clinical changes may be absent. To determine further management tactics, a set of therapeutic and diagnostic measures, you need to personally consult with your attending neurologist, who will conduct a personal examination and evaluate changes in dynamics. You can get more detailed information on the issue you are interested in in the thematic section of our website by clicking on the following link: Computed tomography

Natalya asks:

Good afternoon Age 36, frequent headaches. According to the MR picture, there are single foci of gliosis of a vascular nature in the white matter of the frontal lobes. Mild external hypotrophic hydrocephalus. According to the X-ray data of the SHOP - osteochondrosis, period 2-4. Tell me, what is this all together? Thank you.

Foci of gliosis represent tissue damage of the central nervous system of various types. Proliferating glial cells are supporting cells of nerve tissue that protect and help repair nerve tissue. Considering the vascular nature of gliosis, its probable cause is vascular disorders that could arise against the background of vascular disorders - arterial hypertension, encephalopathy, impaired cerebral microcirculation, as a result of injuries, etc.

I recommend that you personally visit a neurologist for an examination, careful study of research protocols and the appointment of adequate treatment. You can get more detailed information on the issue you are interested in in the thematic section of our website by clicking on the following link: Magnetic resonance imaging (MRI)

Natalia comments:

Thank you very much for your answer. Is it possible to clarify how serious this diagnosis is?

This conclusion in itself is not a diagnosis, but only reflects the changes that have developed against the background of the disease. Your attending physician, a neurologist, can establish an accurate diagnosis after studying the study protocols, reviewing your medical history, complaints, and conducting a personal examination. You can get more detailed information on the issue you are interested in in the thematic section of our website by clicking on the following link: Neurologist and neuropathologist

Natalya asks:

Please tell me what the conclusion means
MRI picture of vasogenic foci of the brain, I am 49 years old, thanks in advance
what to do next

This conclusion indicates vascular changes that may be age-related, associated with cerebrovascular disease, encephalopathy, hypertension, etc. In this situation, I recommend that you personally visit a neurologist to prescribe adequate treatment. You can get more detailed information on the issue you are interested in in the thematic section of our website by clicking on the following link: MRI

Elena asks:

Small focal process in the white matter of the frontal and parietal lobes, the picture is nonspecific, possible as a result of perinatal damage, with stage 1 angioencephalopathy. Suspicion of pituitary microadenoma, prima clinic. Left-sided sinusitis. Decipher it please. 7 years ago I had an operation on the thyroid gland, hemithyroidectomy with removal of paratracheal tissue on the left, I take L-teroxin, TTg 1.9

Considering the existing suspicion of pituitary microadenoma, a personal study of the study protocols and dynamic observation is required, which will make it possible to establish the correct diagnosis and prescribe adequate treatment, therefore I recommend that you personally visit a neurologist.
You can obtain more detailed information on the issue you are interested in in the corresponding section of our website by clicking on the following link: Computed tomography (CT) Neurologist and neuropathologist.

To adjust the dose of L-Thyroxine, it is necessary to evaluate the function of the thyroid gland, so you need to take a detailed test for thyroid hormones, including indicators: TSH, T3, T4, AT-TPO, and also do an ultrasound of the thyroid gland, and then personally consult with your doctor endocrinologist. You can obtain additional information on this issue in the sections: Thyroid gland - hypothyroidism, hyperthyroidism, as well as in the section: Endocrinologist

Svetlana asks:

Good afternoon! On tomography, a 2-year-old child has a white matter cyst on the left and an enlargement of the cerebrospinal fluid spaces. Is this dangerous? When should a repeat tomography be done?

If such changes are present, dynamic monitoring is recommended, including repeat tomography after 6-12 months. You can get more detailed information on the issue you are interested in in the corresponding section of our website by clicking on the following link: Computed tomography. You can also get additional information in the following section of our website: Neurologist and neuropathologist

Julia asks:

Good afternoon. They did the child 2 g 3 m MRI in the conclusion they write signs of focal formation of a cystic nature in the white matter of the temporal lobe of the left hemisphere. brain - local expansion of the Virchow-Robin perivascular space, or a small cerebrospinal fluid cyst. Please tell me. what does this mean and what does it threaten? The child has sleep apnea. Could this be the reason for what is shown on the MRI to be apnea?

Unfortunately, it is not possible to draw a conclusion without personally studying the study protocols. However, a symptom such as apnea can be caused by a cerebrospinal fluid cyst, so I recommend that you personally consult with a pediatric neurologist or neurosurgeon, and also continue monitoring over time - MRI should be repeated at least once a year. You can find out more detailed information on this issue in the thematic section of our website by clicking on the following link: MRI. You can also get additional information in the following section of our website: Neurologist and neuropathologist

Elena asks:

conclusion: MRI signs of Arnold-Chiari I anomaly. Small focal changes in the frontal lobes of both hemispheres of discirculatory origin

Arnold-Chiari malformation is a congenital pathology of the rhomboid brain, often combined with hydrocephalus. If the only symptom of this disease is pain, then conservative treatment is prescribed, including muscle relaxants and non-steroidal anti-inflammatory drugs. If the effectiveness of such treatment is not observed and signs of neurological deficit (numbness and weakness in the limbs) appear, then surgical treatment is recommended.

I recommend that you personally visit a neurosurgeon, who, after conducting an examination and studying the research protocols, will prescribe you adequate treatment. You can get more detailed information on the issue you are interested in in the thematic section of our website by clicking on the following link: Computed tomography (CT). You can also get additional information in the following section of our website: Neurologist and neuropathologist

Valentina asks:

Hello, please explain the MRI diagnosis - a picture of external internal hydrocephalus. Dystopia of the cerebellar tonsils. Focal changes of vascular origin in the white matter of the cerebral hemispheres

The changes discovered as a result of the study are associated mainly with vascular disorders, that is, they could arise due to arterial or intracranial hypertension, atherosclerosis, etc. I recommend that you personally consult with your attending neurologist, who, after carefully studying the study protocols, conducting an examination and studying your medical history, will prescribe you adequate treatment.

Magnetic resonance imaging (MRI). You can also get additional information in the following section of our website: Neurologist and neuropathologist

Natalia asks:

Good afternoon Please decipher the MRI. My dad is 55 years old and has frequent headaches; lately he often gets chills, his whole body shakes for 10-15 minutes, then it goes away. MRI reveals multiple foci of hyperintense MR signal on T2WI and FLAIR ranging in size from 3 to 9.4 mm without perifocal edema.
The third ventricle, up to 4.4 mm wide, is located centrally. On MR angiography, the main artery is elongated and wide. There is asymmetry of the vertebral arteries, the right one is narrower than the left one. Conclusion: focal changes in the brain of a vascular nature, elongated basilar artery.
Is it dangerous? retrocerebellar cyst

Thanks in advance for your answer!

A retrocerebellar cyst is a formation in the form of a cavity or bubble filled with fluid. Such a formation can occur in any part of the brain. In modern practical medicine, such formations are not considered pathological and are considered as one of the options for the structure of the brain. Most often they are discovered by chance during an MRI, since they are not accompanied by any complaints.

The expansion of the perivascular spaces in the area of the basal structures, as well as the expansion of the subarachnoid convexital spaces, are signs of external replacement hydrocephalus - accumulation of cerebrospinal fluid in the ventricular system of the brain due to the fact that its movement to the sites of absorption into the circulatory system is difficult. I recommend that you personally consult with your attending neurologist to conduct an examination and prescribe adequate treatment.

You can get more detailed information on the issue you are interested in in the thematic section of our website by clicking on the following link: Magnetic resonance imaging (MRI). You can also get additional information in the following section of our website: Neurologist and neuropathologist

Nadezhda asks:

I was suffering from headaches, so I consulted a neurologist and was sent for an MRI. The MRI gave the conclusion: an MR picture of a single focus of demyelination in the brain substance. It is also written that in the right frontal lobe, a focus of increased intensity of the MR signal up to 0.5 cm in size with unclear contours is identified subependimally - a focus of residual demyelination. I would like to know the decoding of the diagnosis, because my neurologist cannot decipher and how to treat this disease, I still suffer from headaches, the right side of my face becomes numb, my neck hurts.

The appearance of foci of demyelination is not a diagnosis; it is a symptom that occurs in a group of neurological diseases of an autoimmune nature and in some cases of multiple sclerosis. Also, foci of demyelination can occur after encephalitis, meningitis, influenza, borreliosis, yersiniosis, and brain injuries. In this situation, a detailed study of the neurological status is recommended, therefore I recommend that you visit your attending neurologist, and a study of the immune status is also required, and therefore you need to do an immunogram and personally consult with an immunologist.

Neurologist and neuropathologist. You can also get additional information in the following section of our website: Immunity is the basis of good health

Alice asks:

Hello!
I am 21 years old. From 14 years of age, VSD and hypotension, anemia. They treated me inpatiently, gave me injections, prescribed massage, exercise therapy, physiotherapy, and drank mainly Piracetam, Cavinton, Glycine, and vitamins. In June there was an exacerbation: headaches, worsening memory, vision, poor sleep, emotional outbursts, depression, increased fatigue, nosebleeds, and fainting in the heat and weather changes. previous x-ray diagnoses: signs of hypertension. I contacted a neurologist and was sent for an MRI.
in the white matter of the left frontal lobe, a linear section of a hyperintense T2-WI T2-TIRM mri signal up to 0.4 by 0.2 cm is determined paraventricularly. In the area of the zone of changes, the lumen of the vessel is visualized.
everything else is within normal limits.

The MRI concluded:

MRI picture of a single focal change in the left frontal lobe.

Please decipher the MRI diagnosis and give recommendations if you can.

Such changes may be of vascular origin, but, unfortunately, assessment requires personal examination of study protocols. I recommend that you personally visit your attending neurologist, who will conduct an examination, study the study protocols and then be able to give further recommendations.

Ella asks:

Hello! Help me understand my problem. I am 36 years old. Six months ago, my head began to hurt sharply. There was a strong jump in pressure 170/110. At the moment, I constantly have a headache (temple, occipital part - the pain varies), at night, including stuffy ears, periodically the pressure rises to 150/110, sometimes my hands go numb, or there is a tingling sensation in my fingers, I feel that vision decreases. The neck and spine in the upper part also hurt. I went through some examinations. Here are the results. SCT SHOP-Determines a decrease in the heights of the intervertebral spaces in segments C2-7; compaction of the endplates of bodies C2-7; marginal bone growths along the anterior contour of apophyses C4-6. Manifestations of uncoarthrosis C4-5 and C5-6 are noted. In the atlanto-axial joint, uneven narrowing of the joint space, subchondral sclerosis of the articular surfaces, and marginal osteophytes are determined. Conclusion: CT signs of widespread osteochondrosis of the cervical spine. Artorosis of the atlanto-axial joint, uncoarthrosis. MRI of the head - subarachnoid convexital spaces are slightly expanded in the parasagittal sections of the frontoparietal areas, single grooves are slightly deepened. MRI picture of slight external open hydrocephalus. MRI signs of moderately pronounced inflammatory changes in the mucous membrane of the maxillary sinuses. ECHO results - no displacement of the median structures was detected. Hydrocephalic signs poorly expressed. The M-echo signal is split. Ultrasound of the heart - conclusion: moderate hypertrophy of the left ventricle, impaired diastolic function. Ultrasound of the brachiocephalic vessels - conclusion: the tortuous course of the vertebral arteries on the right and left is hypodynamically significant in segments 1 and 2. Velocity indicators in the vertebral arteries on the right and left are increased (more on the right)—impaired blood flow. Venous dysfunction along the VAV on the left. Ultrasound of the kidneys - no pathologies. Examination by an ophthalmologist - angiopathy of the retinal vessels (signs of moderate intracranial hypertension). Blood test for the lipid spectrum - everything is normal, except for lipoprotein 18.89 (normal 0.00- 11.00), high-density lipoprotein 1.13 (normal >1.15), atherogenic index 3.04 - risk of developing atherosclerosis and ischemic heart disease (normal 0.00-3.00). Are these test results the cause of my headaches, and what treatment is needed? Thank you in advance!

Considering the data provided, it is possible that your condition is associated with many reasons, including hypertension, ischemic heart disease, widespread osteochondrosis and intracranial hypertension syndrome. I recommend that you personally consult with your attending cardiologist and neurologist, who, after an examination, will prescribe you comprehensive, adequate treatment.

You can get more detailed information on the issue you are interested in in the thematic section of our website by clicking on the following link: High blood pressure. Arterial hypertension and in a series of articles: Osteochondrosis

Svetlana asks:

in the cerebral hemispheres there are foci hyperintense on Flair (residual changes). What does it mean?

Please indicate the patient's age, after which we will be able to interpret the changes. You can find out more detailed information on this issue in the thematic section of our website by clicking on the following link: EEG (Electroencephalogram). You can also get additional information in the following section of our website: Neurologist and neuropathologist

Popova asks:

Age 22 years. During the year, there is a disturbance in the menstrual cycle, concrete spotting in the middle of the cycle. My period always comes on time. I was examined, no infections were found, and the harmonica also seemed to be normal. They sent me to do an MRI of the pituitary gland. Results: the gtpophysis is located usually, has dimensions: sagittal - 1.2 cm; vertical - 0.7 cm; frontal -1.6 cm.
The contours of the pituitary gland are clear, even, its structure is uniform due to a small cyst of the intermediate zone with a diameter of up to 0.2 cm. The neurohypophysis is clearly differentiated on T1 VI. The funnel is located sagittally, the optic chiasm is without features, the distance from the superior pituitary cone to the chiasm is 0.3 cm. The siphons of both ICAs are without features. The mediobasal sections of the temporal lobes are not changed, the distance between them is 2.9 cm. The sagittal size of the entrance to the sella turcica is 0.7 cm. Conclusion: MR picture of a small cyst of the intermediate zone of the pituitary gland.
Tell me what does this all mean? And is this related to menstrual irregularities? What to do with a cyst?

The presence of a cyst in the intermediate zone of the pituitary gland can lead to menstrual irregularities, provided that this feature is accompanied by hormonal imbalance. To get an objective picture, we recommend that you take a blood test for sex hormones and personally visit an endocrinologist. You can obtain more detailed information on this issue in the thematic section of our website by clicking on the following link: Hormonal tests - types, principles of implementation, diagnosed diseases.

You can also obtain additional information in the following section of our website: Hormonal disorders in men and women - causes, symptoms, treatment methods and in a series of articles: Vascular changes detected as a result of MRI may be associated with dyscirculatory encephalopathy, intracranial hypertension, and previous head injuries etc. The presence of a maxillary sinus cyst requires a more detailed examination and careful study of research protocols, so we recommend that you personally visit both a neurologist and an oral surgeon, who will examine you and prescribe you adequate treatment (conservative or surgical, depending on the exact location of the cyst, its size , growth dynamics, etc.).

Lusine asks:

Hello! Thank you in advance. I am 29 years old, due to frequent headaches, I had an MRI of the brain and MRA. Conclusion: MR picture of single small foci of altered signal in the white matter of the frontal lobes, most likely of a vascular (dystrophic) nature. Single small cysts in the right maxillary sinus. Option for the development of the Circle of Willis.

These changes are not pronounced or threatening: the variant of development of the Circle of Willis means an anatomical feature and is not a pathology; single small lesions in the white matter can form with long-term vegetative-vascular dystonia, arterial hypertension, intracranial hypertension, etc. I recommend that you personally visit your attending neurologist for an examination and prescription of adequate treatment.

Sergey asks:

MRI picture of the white matter of the brain, more likely of discircular origin, expansion of the subarachnadal convex space. This is the last MRI and this is the EEG.
According to the EEG data, it can be assumed that there are general changes in the electrical activity of the brain of an irritative nature against the background of dysfunction of stem structures with parosysmal activity from the fronto-central region and local parosysmal activity from the right fronto-centre-temporal region. The threshold for convulsive readiness of the mediobasal formations of the temporal lobes is reduced both hemispheres. indirect signs of intracranial hypertension.
doctor what is this and what should I do?

According to the provided conclusion, you have moderate changes in the bioelectrical activity of the brain, there are signs of moderate intracranial hypertension, as well as a decrease in the threshold of convulsive readiness, that is, the possibility of developing a convulsive syndrome cannot be excluded. We recommend that you personally visit a neurologist for an examination and prescription of adequate treatment.

Nature has reliably protected the brain and spinal cord. They are surrounded by several shells. Directly adjacent to the brain is a soft membrane of connective tissue. At some distance from it there is another shell, formed by connective tissue and whose structure resembles a fine network, for which it received the name arachnoid (arachnoid). The space between these membranes is called subarachnoid. The subarachnoid space is filled with cerebrospinal fluid (CSF). The total amount of cerebrospinal fluid ranges from 120 to 140 ml. Above the large grooves and fissures of the brain there are cisterns - areas where the amount of cerebrospinal fluid is especially large. The cerebrospinal fluid comes from the ventricles of the brain, and the outgrowths of the arachnoid membrane absorb it. Impaired circulation leads to expansion of the subarachnoid space.

Reasons for expansion of the subarachnoid space in adults

Poor circulation of cerebrospinal fluid is always associated with some pathological process affecting the brain. This could be a traumatic brain injury, a brain tumor, a stroke, or an infectious brain disease (for example, meningoencephalitis). All these traumatic factors trigger the process of atrophy, the amount of gray and white matter decreases, which leads to expansion of the subarachnoid space. There are three degrees of severity of this disorder: mild - expansion by 1-2 mm, moderate - by 3-4 mm and severe - more 4 mm. Possible clinical manifestations are impoverishment of mental activity, as well as pseudobulbar syndrome, characterized by a triad of symptoms: speech impairment caused by paralysis of the muscles involved in articulation, loss of sonority of the voice (speech becomes whispered) and impaired swallowing. Headaches and blurred vision are also possible due to congestion in the fundus. Timely treatment, including surgery, allows such patients to return to a full life. Even if it is not possible to achieve full work adaptation, a person can at least do without outside help in everyday activities.

Expansion of the subarachnoid space in infants

In infants, the cause of expansion of the subarachnoid space, as a rule, is increased intracranial pressure, birth trauma, or an infection that affects the brain as a result of complications of otitis media or a runny nose. The diagnosis is made according to neurosonographic studies. Often the prognosis is favorable: by the age of two, the subarachnoid space and ventricles of the brain return to normal on their own, and the child seems to “outgrow” the disease. But you shouldn't count on it. This disorder threatens the child with developmental delays, so it must be treated. Treatment is prescribed by a neurologist. It includes B vitamins and other drugs, as well as antibiotics if the disease was caused by an infection.

The cavity between the membranes of the spinal cord - soft and arachnoid - filled with cerebrospinal fluid is called the subarachnoid space. Ligaments that fix the position of the spinal cord pass through this space.

The pathways for cerebrospinal fluid consist of the subarachnoid spaces of the spinal cord and brain and the ventricular system. The ventricles of the brain, whose function is to produce cerebrospinal fluid, are lined with epithelium of various types - cubic and cylindrical. Under normal conditions, they hold less cerebrospinal fluid than the subarachnoid spaces. The walls of the ventricles are quite strong and inflexible, and the subarachnoid spaces change their volume under the influence of various factors.

Liquor plays the role of a shock absorber - it protects the brain from traumatic influences, performs a transport role and immunological functions.

The subarachnoid space of the brain and spinal cord have direct communication with the ventricles of the brain, forming a series of communicating vessels. The outer part of the arachnoid spaces is divided by membranes. This structure forms separate chambers and tanks.

CSF pressure increases briefly with changes in functional states - heavy physical work, stress, even with emotional disorders. With injuries, inflammatory processes of the central nervous system and cancer, its increase increases, which leads to expansion of the subarachnoid space.

Expansion of the subarachnoid space in infants

The subarachnoid convexital spaces in infants expand as the head grows - it increases in circumference. Parents may notice a pathological process by the protrusion of the fontanelles - places of the skull where the bones of the skull converged so that the child could pass through the birth canal without hindrance.

Also, in infants, expansion of the interhemispheric fissure and subarachnoid space is accompanied by a rapid increase in the skull, which leads to the fact that the child cannot raise his head. In this case, a diagnosis is made of perinatal encephalopathy. In addition to the general impairment of the condition, a decrease in reflex function, children become capricious, refuse to eat, lag behind their peers physiologically, and lose weight.

There is another very indicative symptom - “moon gaze”. The eyelids of sick babies are constantly drooping and part of the white is visible from under the skin - the pupil and iris roll under the eyelids. With minor brain lesions, this look appears periodically; with severe lesions, the iris can be seen for a short time.

In children, brain atrophy may also occur, in which expansion of the convexital subarachnoid spaces occurs. The furrows in the frontal, parietal, temporal and occipital regions increase.

The ventricular system is also pathologically deformed due to expansion. In this case, serious examinations are carried out only in the second year of life - earlier, diagnostic measures are considered dangerous to the baby’s life.

Not only computer and tomographic studies may be required, but also the extraction of cerebrospinal fluid using a puncture.

At an early age, children undergo neurosonography - the condition of the cranial cavity can be examined using this method only before the fontanelles fusion.

If a significant area is damaged or leukomalacia is diagnosed - this term refers to softening of the brain, a condition when functional abilities are impaired, impulse signals in the required volume are not sent or received - in the future the child will lag behind in development.

But you shouldn't panic. The child’s body has a great chance of recovery; with timely and adequate treatment – when the first symptoms appear – the chances of recovery increase.

What does moderate expansion of the subarachnoid space in adults indicate?

Expansion of the subarachnoid convexital spaces – uneven or uniform – cannot occur without reason. Impaired circulation of the cerebrospinal fluid is always caused by pathological processes of an inflammatory or traumatic nature, which negatively affect the general condition, cause the ventricles of the brain to spasm, and lead to the expansion of the interhemispheric fissure.

Factors causing this change:

congenital pathologies of the liquor-conducting system;
traumatic brain injuries of varying severity;
infectious diseases – encephalitis and meningitis of various etiologies;
oncological processes of the brain - arachnoendotheliomas, meningiomas and the like.

In these diseases, brain volume increases due to edema, but functional cells of the gray and white matter of the brain atrophy due to increased intracranial pressure.

The amount of cerebrospinal fluid increases, the pattern of convolutions of the cerebral cortex is smoothed out, the subarachnoid space first expands slightly, and then the pathological changes increase.

If treatment is neglected - leaving the victim in a helpless state - then physiological vital activity will not recover on its own, and death is possible. But even with adequate treatment, some brain functions will be lost to a significant extent.

The expansion of convexital spaces is progressing.

There are 3 degrees of severity of such changes:

light, insignificant – up to 2 mm;
average – from 2 to 4 mm;
severe – more than 4 mm.

Symptoms of intracranial disorders: changes in mental activity, sensory and motor disorders, pseudobulbar syndrome.

Pseudobulbar syndrome is a condition during which speech is simultaneously impaired - the functions of sound reproduction are lost, words can only be pronounced in a whisper, and swallowing becomes difficult. This is due to the fact that an uneven change in the position of the hemispheres and their compression leads to disruption of the activity of the cortical centers innervating the muscles of the pharynx and larynx, which leads to paralysis or paresis of the muscles of the larynx.

Surgical treatment does not always help victims; complete adaptation to work and life is practically impossible to achieve. However, with timely treatment, it is possible to restore a person’s ability to perform daily activities – when caring for himself – without outside help. In some cases, thinking abilities and intellectual qualities are preserved.