What treatment would you suggest seeing this MRI?

Question

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.

Answer 1

Hello,

Welcome to icliniq.com. Based on the information reviewed (attachment removed to protect patient identity), the MRI brain was likely performed based on clinical suspicion. The MRI revealed bilateral oval hyperintensities without diffusion restriction, indicating old (chronic) infarcts commonly seen in hypertensive patients. The deficits resulting from these infarctions depend on their specific location, and medical management is typically sufficient. I suggest strict blood pressure control and the use of Ecospirin AV (75/10) tablet once daily at night, which is a combination of Aspirin and a statin. It is important to consult with a specialist doctor, discuss the treatment plan, and obtain their consent before taking any medication. To rule out stenosis, a fasting lipid profile and ultrasound Doppler of the bilateral carotid arteries are recommended. Additionally, physiotherapy for gait training should be considered. It would be beneficial to seek a neurologist's opinion for a detailed neurological examination to rule out dementia syndromes. Regarding the MRI spine findings of multiple disc problems and pressure on the spinal cord, further management decisions should be based on clinical examination and correlation with the imaging findings. I advise consulting a spine surgeon or neurosurgeon for a physical evaluation and further guidance. It is important to continue with the prescribed anti-hypertensive and thyroid medications.