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Alzheimer's Disease

Breaking Down Periventricular White Matter Disease

09/12/2006

Question:

I am 64 years old and had an MRI of the brain with and without gadolinium. "The impression: Periventricular white matter disease with a very small cortical defect in the right cerebellar hemisphere, This is unchanged from the previous study. The white matter disease has worsened since the previous study. However, no acute infarct or hemorrahage is seen".

Can you explain in simple words? Do I need to get another MRI to check if it has worsened again? Thanks.

Answer:

I would suggest that you ask your physician to review your MRI images with you. Some radiologists will comment on even the slightest amount of white matter changes, and if that is the case, it is of little concern. Extensive white matter changes are more often associated with cognitive impairment or sometimes associated with mood issues, but I have seen fairly significant white matter changes in fairly intact individuals.

In a young patient with a history of neurological deficits, multiple sclerosis would be the main worry. In an older patient with a history of neurological deficits, stroke would be the main worry. In someone without a history of neurological deficits, it is less clear. In order to determine which applies to you, one would have to review the images- as the radiologist didn’t comment on how extensive the white matter changes are (or were to begin with).

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Response by:

David Q Beversdorf, MD David Q Beversdorf, MD
Formerly
Assistant Professor of Clinical Neurobehavior and Neurology
College of Medicine
The Ohio State University