Confusing MRI Results at 19: Seeking Clarity on Hippocampal Asymmetry
Hello everyone, I'm a 19-year-old AFAB trans man, standing at about 5'5" and weighing around 218 pounds. I’ll provide a brief overview of my medical background. I deal with several health issues, including asthma, chronic pain syndrome, hypermobility syndrome, and the aftermath of a car accident that left me with a fractured pelvis. Additionally, I suffer from vestibular migraines and another condition causing facial numbness, the name of which I struggle to spell and pronounce. When I was seven, I contracted Epstein-Barr virus (EBV). Currently, I'm on testosterone gel, Lamictal, pantoprazole, and occasionally use 5mg edibles for pain management. I recognize that some may not agree with my choices. At the age of 11, I was assessed for absent seizures and my EEG showed generalized spikes during eye closure, but no treatment followed, nor was I given an explanation. Thankfully, my MRI appeared normal at that time. Lately, I’ve experienced diverse neurological symptoms, such as changes in vision, episodes of spasticity affecting my hands and legs, unintentional crashes into walls, stumbling, and difficulty with speech. I even had a car accident due to these issues, which was extremely embarrassing. Fortunately, I escaped injury, but the car and the shrub I ran over, along with my pride, did not fare so well. In light of these symptoms, I sought a neurological consultation, and prior to my appointment with the neurologist, my physician's assistant ordered a neck X-ray and a brain MRI. The X-ray results were clear, which wasn't surprising. However, the MRI revealed some unexpected findings. Everything appeared normal until I reached the hippocampal asymmetry report, which stated: "Hippocampal asymmetry quantitative analysis: Based on age-matched controls, normative percentiles for hippocampal volume are 52.00% on the left and 13.00% on the right. The asymmetry index stands at 11.88, with a percentile ranking of 99.00%." This triggered a concerning thought: "Nothing in my brain should be hitting the 99th percentile—this can’t be good." Additionally, my HOC score plummeted to about 52%, which I learned is not favorable either. Strangely, despite the irregularities in my hippocampi, there didn’t appear to be any signs of atrophy. When I compared this MRI with an older report showing symmetrical hippocampi, I was puzzled by the significant change over eight years. It raised the question: How can there be no atrophy if my hippocampus has seemingly altered? Is it possible that something akin to squeezing a stress ball caused this imbalance? Moreover, the report fails to clarify the origin of my symptoms; all I found on Google was that similar issues are often seen in Alzheimer’s patients, which left me feeling alarmed. This leads me to a point of confusion: What does this all signify? I realize that an online community cannot provide a diagnosis, but should I be preparing for the worst? How can I effectively advocate for myself in this situation? Is every MRI report designed to induce worry? Can someone have asymmetrical hippocampi after having normal ones years ago without experiencing atrophy? Do these findings provide any insight into the issues I’ve been facing, or are they unrelated?
Answers (1)
2/18/2026, 2:30:54 AM
OpenHealth AI
You have raised several important concerns regarding your recent MRI results and ongoing neurological symptoms. Let’s break this down to clarify the significance of your findings and provide actionable steps to help you navigate this situation.
Summary of Main Points:
- The MRI showed asymmetry in your hippocampi, but no signs of atrophy.
- You’re experiencing concerning neurological symptoms, which need careful consideration.
- You’re seeking clarity about the potential implications of your MRI results and how to advocate for your health.
Explanation:
The hippocampi are critical brain structures involved in memory and spatial navigation. Asymmetry can sometimes occur naturally and may not indicate a serious issue, especially if there is no atrophy (shrinkage of brain tissue). The high percentile ranking of your asymmetry does raise questions, but it's essential to note that MRI findings can vary significantly from person to person. Changes in the hippocampus without atrophy do happen and can stem from various causes.
Your symptoms—changes in vision, spasticity, unintentional movements, and speech difficulties—are concerning and warrant thorough evaluation. While it is understandable to feel alarmed upon reading that some similar findings can be associated with conditions like Alzheimer's, keep in mind that many factors affect these results, and a definitive diagnosis cannot be drawn solely from an MRI.
Actionable Next Steps:
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Continue Your Neurological Consultation:
- Share your complete symptom history and the MRI results with your neurologist.
- Ask specific questions about the significance of your hippocampal asymmetry and how it could relate to your current symptoms.
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Request Further Testing if Necessary:
- Depending on your neurologist's guidance, ask about additional tests (e.g., neuropsychological evaluation, blood tests, or possibly a repeat MRI) that could provide more information.
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Document Your Symptoms:
- Keep a symptom diary to track when your symptoms occur, their severity, and any potential triggers. This documentation can be invaluable for your neurologist to understand your situation better.
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Self-Advocacy:
- Express your concerns clearly to your healthcare providers. If you're feeling worried about the implications of your MRI, prioritize addressing those feelings in your next appointment. Don’t hesitate to seek clarification on any terms or findings you don’t understand.
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Manage Stress and Well-being:
- Consider engaging in stress-relief practices (such as meditation, gentle exercise, or breathing exercises), which may alleviate some of your symptoms and improve overall well-being.
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Limit Online Research:
- Be cautious about interpreting medical information found online. Instead, focus on discussions with your healthcare team for tailored and accurate advice.
You're taking a proactive approach to your health, which is essential. While it's understandable to feel concerned about your results, remember that many brain variations are benign, and your healthcare team is there to help clarify what this means for you. If you have any other questions or need further support, feel free to reach out.
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