What could be causing my difficulty in walking steadily?

Question

Hello doctor,

I consulted a neurologist in my area, and he advised me to undergo an MRI brain scan due to difficulty in walking steadily. Please review the attached MRI report and let me know if there are any issues or abnormalities noted in the scan.

Here are the MRI findings:

No obvious CP angle lesion seen.
The internal ear signal appears to be maintained.
Brain stem appears normal.
No areas of diffusion restriction were noted in the brain.
The cerebellar hemispheres show prominent sulci.
The third and lateral ventricles appear normal.
The cisterns and sulci appear slightly prominent.
The cerebral hemispheres show no major altered signal changes.
Mild thinning of the corpus callosum is noted at the mid-body level.
A prominent CSF space is noted at the sella, giving a partial empty sella appearance.
Visualized orbits appear normal.
Sinuses appear aerated.
Visualized intracranial circulation shows a normal flow void signal.
Craniovertebral junction and cervicomedullary junction appear within normal limits.
Thin subdural hygromas are noted in the frontal region, measuring about 2mm in thickness.

Impression:

Diffuse mild cerebellar atrophy.
No recent infarct or hemorrhage seen.
No CP angle or brain stem lesion seen.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have carefully reviewed your MRI (magnetic resonance imaging) brain report (attachments removed to protect the patient's identity). Overall, there is no serious or dangerous problem seen in the scan. There is no stroke, no brain bleed, no tumor, and no brainstem or inner ear lesion, which is reassuring.

The MRI shows mild cerebellar atrophy, meaning there is a slight shrinkage of the cerebellum. The cerebellum is the part of the brain that helps with balance and coordination, so this finding can explain your unsteady walking. This change is mild and slowly progressive, and it is commonly seen with aging or long-standing balance issues.

There are thin subdural hygromas (about 2 mm) over the frontal areas. These are small collections of fluid, usually harmless, and do not cause pressure on the brain. At present, they do not require surgery, only observation.

The report also mentions a partially empty sella, which is a common incidental finding. It usually does not cause symptoms and is often unrelated to walking problems. All other structures, the brainstem, ventricles, blood flow, sinuses, and orbits, are normal. There is no recent infarct or hemorrhage.

Therefore, your walking difficulty is most likely related to mild cerebellar changes. I recommend clinical correlation, balance assessment, physiotherapy for gait training, and follow-up with your neurologist. Further tests may be advised only if symptoms progress.

Please do not worry; this is a non-emergency and manageable condition.

I hope this helps with your query.

Thank you.