Topic: MRI of brain: "Flow voids are identified." Normal finding?
hshbmom
Frequent Contributor (1K+ posts)
Member # 9478
posted
Hi fellow lymies,
I was looking at the report from dd's brain MRI. It states..." No focal white matter disease identified....Flow voids are identified in the major intracranial vessels, including the dural sinuses."
All else was unremarkable.
Are flow voids normal?
Are flow voids areas of abnormally restricted blood flow?
This test was done 8-22-06. Since that time dd has developed several other neurologic problems. The neuro said don't come in right now.....just wait until dd's follow-up visit next month!
Does this sound right? Dd had a tick bite with rash this past spring. I've suspected LD for months, but she was just diagnosed this month and is finally being treated.
She's on azithromycin and cefprozil...do these reach the brain? Is this targeting the general bacterial count? ....or the brain? She has neuro and joint/neck-to-tailbone, hip & knee pain. Today she has new pain in her hands and arms.
I thought treatment should arrest further development of symptoms???? Maybe these new symptoms can be attributed to a herx????
Nancy
Posts: 1672 | From AL/WV/OH | Registered: Jun 2006
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posted
Is this a Lyme literate Neuro or a duck neuro?
No, this does not sound normal to me (But I am not a neuroradiologist or doctor of any kind!)
Flow voids on brain imaging can refer to the CSF. Lyme can cause normal pressure hydrocephalus (NPH)by interfering with the subarachnoid CSF flow.
If intracranial pressure is increased, lyme disease may cause presentation of psuedotumor cerebri. This has been documented more in children than adults. If this is the case, a lumbar puncture may be needed to relieve the pressure.
If it is circulatory issue, that is another story.
I do not want to scare you but if this were my child I would want them to see a LLMD as soon as possible. If it is increased intracranial pressure or blood flow problems this needs further attention.
I would not hesitate to get a second opinion.
-------------------- **Eat Chocolate** Posts: 942 | From USA | Registered: Mar 2005
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hshbmom
Frequent Contributor (1K+ posts)
Member # 9478
posted
This impression was made by a radiologist, not a neurologist. It was an MRI with and without contrast.
The pediatric neurologist is not LL. She did listen to dd's history. I also explained my history & the numerous neurological problems I was having. The neuro thought if dd had LD I should take her to the big teaching children's hospital.
Most physicians here know nothing about LD because they don't believe we have LD here...they attribute the signs to an environmental toxin. They're absolutely right...ticks are carrying the environmental toxins.
I brought the radiographer some literature explaining the changes that might be seen in a brain with LD. At the time of the MRI she had not been diagnosed with Lyme disease.
I explained she had a rash at the site of a tick bite and I suspected she might have LD. I also told them I had a rash & bite and HAD beeen diagnosed with LD.
The radiologist typed his impression on bold capital letters: NO EVIDENCE OF LYME DISEASE BY MR CRITERIA.
The technique used was a "sagittal T1, axial T1 with and without contrast, T2, diffusion-weighted, flair, GR, and thin section coronal T1 with contrast and FLAIR sequences obtained with speciall attention to the temporal lobes."
I contacted a LLMD neuro with a good reputation...but the receptonist told me "the CDC had pressured (this doctor) into not diagnosing LD anymore." I'll have to look elsewhere for a LLMD neurologist...or at the least, ask dd's LLMD about it.
Imanurse, you're saying the flow void could be in the CSF fluid or the blood flow. This study was with contrast, so might I assume they meant a blood flow problem? I realize I shouldn't assume this.
I just re-read the impression...it states the flow voids are in the major intracranial vessels. That would be BLOOD vessels wouldn't it? They don't call the spaces where the CSF is "vessels". But then it goes on to say "including the dural sinuses" ....which could be CSF in the sinuses...right????
I have a radiologist friend I'm calling now...and dd's LLMD...and dd's neuro. I need an answer. ...especially with the increased neurological symptoms in the past 2 weeks.
[ 23. October 2006, 10:23 AM: Message edited by: hshbmom ]
Posts: 1672 | From AL/WV/OH | Registered: Jun 2006
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lymemomtooo
Frequent Contributor (1K+ posts)
Member # 5396
posted
Look up hypo perfusion and see if that could be it. My daughter has many areas of this and the radiologist said antibiotics for lyme might help this..Seh refuses abx.
She won't take them so now we must decide what Dr or Duck to go to for a brain damaged problem..I am very confused with the choices.
One does spect scans to determine the problem and then chooses the appropriate psych drugs. The llmd says psysh drugs may not help. The other drs do something like bio feedback.
So good luck..Wish I had better answers. lymemomtooo
Posts: 2360 | From SE PA | Registered: Mar 2004
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Marnie
Frequent Contributor (5K+ posts)
Member # 773
posted
I found this:
"Normally,
the dural sinuses have sufficient flow to
exhibit a flow void.
If that flow void is missing or if the sinuses are hyperintense, thrombosis should be suspected."
This means there is nothing blocking the flow like a clot/tumor or just narrowing.
Sounds okay.
Posts: 9426 | From Sunshine State | Registered: Mar 2001
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posted
I could be wrong --- But I didn't think that the MRI showed blood flow at all, I though just the tissues were shown. I thought that blood flow could only be seen by a Brain Spect???
But I don't have medical background or a technical brain in fact..... I'm lucky I can understand half of the stuff written in here..... sheesh!
My MRI showed flairs in the white matter, but my Brain Spect show mild global cortical hypofusion. Which I understand to mean low blood flow to the brain.... No wonder I can only understand HALF of what is said here.
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