MRI Findings of White Matter and Widened MCA
A 27-year-old female, standing 173 cm tall and weighing 170 lbs, has experienced significant changes in health. After giving birth last year, she managed to shed 2 stone. The only medication she takes is Mounjaro. Approximately two months ago, she began to experience new headaches, which prompted her general practitioner to refer her to a neurologist. An MRI was conducted to investigate potential underlying issues. The results of the MRI indicated the presence of 'chronic ischemic changes affecting the bilateral centrum semiovale and periventricular white matter.' Furthermore, there is a noted dilation of the right MCA artery, described as aneurytic. Other areas of the MRI appear normal. Following these findings, she was subjected to a magnetic resonance angiography (MRA) to further examine the blood vessels and exclude any signs of inflammation. The results of this scan are still pending. Initially, there were suspicions of vasculitis, but this has since been dismissed. In addition, she underwent blood tests that included panels for autoimmune and connective tissue disorders, which have returned normal results. She is anxious about the implications of her MRI findings and is struggling to obtain clear answers from the hospital regarding her condition and its seriousness.
Answers (1)
8/31/2025, 10:12:55 AM
OpenHealth AI
The MRI findings you've shared indicate some chronic changes in the brain’s white matter and a dilated right middle cerebral artery (MCA). It’s understandable that you’re feeling anxious about this situation, especially with ongoing headaches and the uncertainty of the MRA results. Here’s a clearer breakdown of your findings and what you can focus on as next steps.
Key Points:
-
Chronic Ischemic Changes: These changes in the white matter can sometimes suggest that there have been issues with blood flow to these areas for a prolonged period. This might be associated with various factors such as lifestyle, vascular health, or sometimes even previous undetected conditions.
-
Dilation of the MCA: The dilation of the right MCA, noted as “aneurytic,” requires careful follow-up because it could be a risk factor for future complications, especially if there's a significant increase in size.
-
Pending MRA Results: The MRA should provide more information on the blood vessels in your brain and will help rule out serious concerns such as vascular inflammations or abnormalities.
Next Steps:
-
Stay Informed: Continue to ask for updates on the MRA results and communicate any new or worsening symptoms you experience, such as changes in headaches, vision, or strength.
-
Monitor Symptoms: Keep a diary of your headaches—note when they happen, how long they last, their intensity, and any accompanying symptoms. This information can be very helpful for your healthcare team.
-
Manage Anxiety: Anxiety can be a normal reaction to such findings. Consider engaging in relaxation techniques such as mindfulness, yoga, or other stress-reduction strategies to help manage your feelings.
-
Follow-up Appointments: Ensure you have a plan for follow-up with your neurologist to discuss the MRA results and any further recommendations.
-
Lifestyle Considerations: While awaiting further assessment, maintaining a healthy lifestyle—including balanced nutrition, regular physical activity (as tolerated), and avoiding smoking—can be beneficial to your overall vascular health.
It's crucial to remember that many chronic conditions can be managed effectively with appropriate care and monitoring. Continue to voice your concerns with your medical team as they can provide further clarity and assistance specific to your situation. You're taking important steps by seeking information and support, which is invaluable during this time.
Related Questions
Navigating Health Concerns: A Young Woman's Plight with Chronic Migraines and Stress
To summarize a very complex situation, last spring in 2025 was exceptionally challenging for me. I faced overwhelming stressors, including family deaths, eviction, and my parents splitting up. This turmoil led to chest pains so severe that I had to visit the emergency room because I couldn’t breathe deeply without experiencing intense pain. The doctors attributed the issue to psychological causes, but I continued to suffer from pain and instances of fainting due to the stress, which worsened as yet another family member was diagnosed with cancer. My psychiatrist suggested medication, and I started on Lexapro and Concerta, which improved my condition somewhat, even though I remained fatigued and felt like I was merely surviving. By the end of August, I contracted a severe case of bronchitis that caused me to experience fevers even while doing laundry. It seemed I was verging on pneumonia, prompting the prescription of prednisone and other steroid medications. Thankfully, I began to recover quickly, but soon after, I was plagued by persistent headaches and an overwhelming sense of paranoia that someone was out to get me. After another emergency room visit, the physicians informed me that, although my symptoms—such as fever, intense pain, night sweats, sensitivity to light, ear pressure, and a stiff neck—were alarming, they were likely just severe migraines that should eventually fade. Unfortunately, they didn’t. I returned to urgent care for further treatment, received antibiotics, and was advised to consult a neurologist. While the antibiotics provided some relief, my symptoms intensified. My primary care physician eventually prescribed sumatriptan, a medication intended to alleviate migraine pain, but instead, it exacerbated the headache. For the next two to four weeks, I endured an exceptionally difficult time, facing numerous strange symptoms that felt worthy of immediate attention, yet each visit concluded with a migraine diagnosis and a waiting period for my neurology appointment. My frustrations pushed me to contemplate risky alternatives for relief, but I resisted, feeling utterly hopeless and unable to cope. I sought an ear, nose, and throat specialist to rule out sinus issues, which turned out to be fine. A painful spot under my jaw led me to suspect nerve involvement, and I visited the emergency room again due to experiencing stroke-like symptoms (including mild left arm weakness, extreme headache, and minor speech issues). Sadly, I was again told it was merely a headache, and the IV medications were ineffective. During my annual check-up, my primary care provider was unfamiliar with my ongoing issues but discovered an enlarged lymph node in the lower left side of my neck and a cyst on my thymus after conducting a soft tissue scan. She reassured me that there was no need for concern and suggested waiting for my neurology visit or getting my eyesight checked. Despite my yellower complexion, increasing stiffness, and joint pain, I accepted her recommendation. While I mentally adapted to the chronic pain, which was always present, it affected my ability to concentrate and engage in daily life. I tried consuming plenty of lemon juice and engaging in lymphatic drainage massages, which provided transient relief and halted my yellowing skin. Now, in the present, I've noticed a peculiar, raised red bump on the side of my foot. It’s hard, tender, and smaller than a dime, without any accompanying rash. It has persisted for a couple of weeks without causing pain while walking. Additionally, more lymph nodes in my neck have become swollen, I have experienced difficulty swallowing, and I occasionally choke on air. My lungs feel heavier with a diminished sense of smell, though I don't have the thick mucus typical of a cold. The headaches, however, are reemerging, sharper than before, which is a concerning development. Throughout all of this, my blood pressure has remained within a low yet stable range, and my blood tests and CT scans have shown no significant issues. I haven’t consumed anything excessively that might raise concern, including food or drugs. Am I truly facing a serious health crisis? Should I prioritize getting another appointment, or do I need to rush to urgent care? I'm scheduled to see the neurologist in about a month, and I'm wondering if I should ask my primary care provider for some preliminary tests like blood work or an MRI beforehand. If so, what specific questions should I prepare for my neurology visit? I believe the pain has a genuine physical basis, although my anxiety definitely amplifies the experience.
Injury to the Sciatic Nerve
At 25 years old and weighing 135 pounds, I am currently taking naproxen and Lyrica to manage my sciatic nerve injury. The pain in my right leg has made it incredibly difficult for me to remain upright. It’s been two weeks since I first sought treatment; I consulted a physician who advised medication and attended a physiotherapy session. Initially, I experienced some relief after the appointment, but unfortunately, the pain returned the following day—even the prescribed home exercises exacerbated my discomfort. Just yesterday, I attempted the cobra pose, along with the flossing technique, which only heightened my pain. I find it nearly impossible to stand for more than a few seconds before the discomfort becomes intolerable. Additionally, I have an appointment with an osteopath on Tuesday, but I can't shake off my worries— is it normal to still struggle with walking after two weeks? Although I am experiencing some numbness in my toes, I haven’t encountered any loss of bladder or bowel control, worsening numbness, or weakness in my legs, so I feel stable in that regard. Nonetheless, I fear the possibility of never fully recovering and being left with a lasting disability. The pain is overwhelming, adding to my anxiety about the future.
Assessing My Health Concerns: How Anxious Should I Be?
I’m a 32-year-old woman, weighing 124 pounds and standing at 5 feet 6 inches tall. For over a year, I have been experiencing bright red rectal bleeding. Initially, I attributed this issue to hemorrhoids that developed during my pregnancy two years ago. The bleeding occurs with most of my bowel movements, sometimes happens without one, and on a few occasions, has been enough to stain the toilet bowl significantly. The color of the blood is typically darker than what I observe during a hemorrhoid flare-up. There is a notable family history of bowel cancer on both sides; one family member was diagnosed at age 45, and another at 60. In the past six months, I have encountered several episodes of severe abdominal pain—3 to 4 instances—intense enough to consider a trip to the emergency room. However, the pain usually subsides within about an hour. It’s unusual for me to experience such acute pain, given my high tolerance for discomfort; for example, I once played rugby shortly after dislocating and fracturing my finger. Recently, I mustered the courage to consult with my doctor, who recommended a FIT test, which returned a positive result (30.1). Additionally, I underwent a complete blood test, and aside from having low ferritin levels (7 µg/L), all other results were normal. I have since been referred for a colonoscopy on a two-week waiting list to rule out any possible bowel cancer. Given these circumstances, how concerned should I be? Thank you for your input.
Understanding Possible Seizure Triggers and Recurrence Risks
Health Background: I am a 21-year-old female, standing at 169 cm and weighing 65 kg. Over the past three years, I have been using oral contraceptives. As of this morning, I started taking 25 mcg of levothyroxine along with a weekly vitamin D supplement of 0.266 mg. Recently, I was diagnosed with hypothyroidism and found to have a vitamin D deficiency that I suspect has existed for the last three years. I do not consume alcohol or smoke, and I can confirm I am not pregnant. Two years ago, I experienced a mild concussion. I currently reside in Spain. A couple of months back, in mid-December, I blacked out twice. The second occurrence took place while I was at the doctor’s office after seeking urgent medical care for the initial incident. Following the second episode, I underwent a CT scan and an EKG, both of which returned normal results. Further tests, as directed by my physician, revealed a critical vitamin D deficiency and hypothyroidism; however, he expressed doubt that either of these conditions led to my loss of consciousness. I was then referred to a neurologist, and I am presently awaiting an appointment. Although the waiting period is lengthy, my doctor indicated that I should receive priority for scheduling, although the exact timeframe remains uncertain. The referral document summarized my events, labeling the second episode (which the physician witnessed) as a potential seizure devoid of tonic-clonic movements—a revelation that took me by surprise. After regaining consciousness, I felt extremely disoriented and terrified, struggling to process what was happening. I have no prior history of seizures, epilepsy, or any related conditions, and there is no known family history of these issues. If this indeed was a seizure, what might have triggered it? Additionally, what is the likelihood of experiencing another one? Since that time, I have not had any further incidents, but I have experienced moments where I felt a sense of impending doom, which I managed to overcome. I intend to wait for the neurologist's evaluation, but the uncertainty surrounding a possible neurological condition is quite distressing. Thank you for any insight you can provide!
Understanding EEG Results for My 22-Month-Old Son: Insights Needed
Could someone help clarify this for me? My son, who is just 22 months old, hasn’t started walking yet, becomes tired easily, and has been experiencing behavioral outbursts. He had a febrile seizure in February 2025, followed by another unexplained seizure in April 2025, which led us to consult a neurologist. Since he was 3 months old, he has been receiving therapy from a physical therapist for torticollis. At birth, he spent five days in the NICU due to issues with meconium aspiration. A recent MRI showed normal results, and he also had a follow-up EEG after one conducted in July 2025. The results from this recent EEG were abnormal for a pediatric patient in awake, drowsy, and sleeping states. Notably, there were brief episodes of left frontotemporal delta slowing, which occurred mainly when he was awake and drowsy. There were no signs of epileptiform activity detected. In contrast, the EEG performed back on July 3, 2025, was deemed normal for both awake and drowsy states, again with no evidence of epileptiform irregularities, although it did not capture any sleep data. This examination was prompted by the child's existing history of febrile seizures. Importantly, he is not currently on any anti-seizure medications. The EEG procedure used standard electrode placements per the 10-20 system, conducted a single-lead EKG, and included continuous video monitoring. During the analysis, the background activity was symmetric, indicating some anterior-posterior (AP) organization, with a dominant rhythm of 50-80 microvolts at 7 Hz. His drowsy state was marked by a reduced amount of eye blink activity, less breathing motion interference, and a generalized slowing in theta/delta frequencies. Stage II sleep exhibited spindles and vertex waves patterns. Additionally, there were intermittent bursts of 250-300 microvolts in the left frontotemporal region with semi-rhythmic activity of 2-4 Hz, mostly observed during wakefulness and drowsiness. No definitive epileptiform discharge was noted. Photic stimulation during the test did not elicit a strong response, and hyperventilation was not conducted during this session.