Wednesday 15 April 2015

Frontal subcortical white matter cystic lesions MRI

A 30 y o male with headache.
MRI Brain with contrast shows:

Multiple T2 hyper intense well defined cystic foci in right frontal sub cortical white matter.
Lesions are iso intense to Csf on all pulse sequences.
No abnormal enhancement on post contrast T1.
No obvious restricted diffusion or hemosiderin staining on GRE in corresponding region.
No significant mass effect.
No adjacent white matter Gliosis.
No obvious calcification on CT sections.
Rest of the MRI brain within normal limits.

These appears to be benign lesions, and incidental finding not related to patient's headache.
Possibility given was Enlarged peri vascular spaces ( ' V R Spaces') and advised EEG correlation.
EEG was unremarkable.

Follow up imaging after 6 month revealed no change which again favors imaging diagnosis of Enlarged peri vascular spaces.

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