Q. What treatment would you suggest seeing this MRI?

Answered by
Dr. Naresh Kumar Monigari
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Jun 29, 2016 and last reviewed on: May 19, 2020

Hi doctor,

This is in regard to my mother. She is 51 years old. Her weight is 112 kg. She has severe pain in the lumbar spine till her bottom and not the legs. She had done an MRI of her spine earlier and got detected with slipped discs. Recently, she did another MRI of her brain and whole screening of spine. I want you to explain the conclusion of the brain MRI. The report was round to oval T2 hyperintense foci in bilateral deep peritrigonal and right frontal white matter. Please explain in detail and also please tell me what treatment would it require. Also, she has slipped discs, frozen shoulder and muscle knots. Please tell a solution for muscle knots. Due to frozen shoulder, she cannot lift her right hand. She had injections, but did not get relief. From a while back, she is showing forgetfulness, no balance and cannot lead a normal life at all. I am sending the copies of the MRI and also attached her current medication list. I will be awaiting your reply. Thank you.

Dr. Naresh Kumar Monigari

General Medicine Internal Medicine


Welcome to icliniq.com.

I had gone through all the data posted (attachment removed to protect patient identity). I would like to keep my answer as simple as possible so that you can understand easily.

  • Regarding MRI brain, why MRI brain was done? On what suspicion doctor has advised MRI brain?
  • It shows bilateral oval hyperintensities without restriction on diffusion imaging suggests old (chronic) infarcts. That we commonly describe as deep white matter ischemic changes that are seen in hypertensive patients.
  • The deficit from infarction in brain depend upon its location. For that only medical management is sufficient.
  • I suggest strict control of blood pressure and tablet Ecospirin AV (75/10) once daily at night. It is a combination of Aspirin and statin. Consult your specialist doctor, discuss with him or her and take the medicine with consent.
  • You can get her fasting lipid profile and ultrasound Doppler of bilateral carotid arteries to rule out stenosis.
  • She also needs physiotherapy for gait training.
  • It is good to get a neurologist opinion regarding to rule out dementia syndromes that needs detailed neurologic examination.
  • Regarding MRI spine; there are multiple site disc problem and pressure on the spinal cord.
  • With clinical examination we need to correlate imaging finding and then decide on further management. Kindly consult a spine surgeon or neurosurgeon for physical evaluation and for further advice.
  • Continue anti-hypertensives and thyroid medications.

For further information consult an internal medicine physician online --> https://www.icliniq.com/ask-a-doctor-online/internal-medicine-physician

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