HomeAnswersNeurologyct scanI am experiencing sudden dizziness. Please advise.

My brain CT shows hypodensities under the putamen. Does this warrant a brain MRI?

Share

The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Answered by

Dr. Hitesh Kumar

Medically reviewed by

iCliniq medical review team

Published At May 22, 2017
Reviewed AtFebruary 8, 2024

Patient's Query

Hello doctor,

I am a 32 years old male. I have been having sudden dizzy spells from the last month. I had a normal eye and heart tests, which were also reassuring, I have moderately high blood pressure. The doctor told me to get a brain computed tomography (CT) scan, and the reports came back normal. However, the description notes read, hypodensities bilaterally under the putamen, which aspects indicate Virchow-Robin spaces. I had a previous computed tomography (CT) scan five years ago, which did not find this. How is the conclusion note in the report normal? I read on the internet that these spaces can actually be ischemic lacunes and symptom of an ischemic attack. Does this warrant an magnetic resonance imaging (MRI) scan? Thank you in advance.

Answered by Dr. Hitesh Kumar

Hello,

Welcome to icliniq.com. I would like to know some details about your symptoms: 1. What exactly happened during the dizzy spell? 2. Do you feel your surrounding rotating around you? Or feel your head spinning? 3. Do you feel blackening in front of your eyes, heart rate getting faster, sweating, and feeling of impending doom? 4. Do you fall during these episodes? How long does this episode last? 5. Why did you get a computed tomography (CT) scan of the head five years ago? What symptom did you have that time? 6. Do you have any other medical problem? 7. Are you taking any medications for your problem? 8. Do you have a hearing problem, discharge from the ear, or tinnitus? Millimetric hypodensities bilaterally in putamen can beVirchow-Robin spaces or lacunar infarcts. But these lesions in putamen does not explain your current symptoms. I suggest you get an magnetic resonance imaging (MRI) of the brain with temporal sections, to look at your posterior part of the brain and a part of the inner ear. CT scan is not a sensitive investigation for posterior structures of the brain.

Patient's Query

Thank you doctor,

I am dizzy every day, especially when I am in front of the computer or lying on the bed. A couple of times, I have had more violent ones as if my head would be hit or something. I never vomit, lose consciousness, fall, or lose balance, and I continue talking or moving. I did have a flashback once, which lasted for a microsecond. My basic neurological examination like electroencephalography (EEG), basic reflex, and balance tests, were normal. Also, I never have this feeling when I am exercising, on the contrary, I feel better, and my head is less oppressed. Is an magnetic resonance imaging (MRI) needed? It is quite expensive, and my doctor said we could do it, but only to reassure me, so I would like to be sure if it is worth it. Should I not worry about the Virchow-Robin spaces?

Answered by Dr. Hitesh Kumar

Hello,

Welcome back to icliniq.com. If you are able to do all your activity without any problem at the time of dizziness, your dizziness seems non-specific. In such description, one possibility which I can think is BPPV (benign paroxysmal positional vertigo). But, I am not sure without being in front of you and cross questioning your symptoms. If this dizziness happens while sitting in front of a computer, I also suggest you go for ophthalmology examination for refraction, vision, intraocular pressure, and fundus examination. I do not think you should worry about Virchow-Robin spaces. Even if these are lacunar infarcts, then also they do not explain your symptoms. MRI seems not to be warranted. But, there is no harm in getting magnetic resonance imaging (MRI) of the brain, other than the cost. If it comes out to be normal or non-specific, your anxiety about your symptoms will be resolved. Otherwise, you will keep on worrying in future, if you again have a dizziness spell.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Hitesh Kumar
Dr. Hitesh Kumar

Neurology

Community Banner Mobile
By subscribing, I agree to iCliniq's Terms & Privacy Policy.

Ask your health query to a doctor online

Neurology

*guaranteed answer within 4 hours

Disclaimer: No content published on this website is intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek advice from your physician or other qualified healthcare providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website. Read our Editorial Process to know how we create content for health articles and queries.

This website uses cookies to ensure you get the best experience on our website. iCliniq privacy policy