Michael's Brain?

by Michael S. Kaplan, published on 2006/09/14 02:57 -04:00, original URI: http://blogs.msdn.com/b/michkap/archive/2006/09/13/753262.aspx

Lots of you who are regular readers probably don't pay much attention to the text over on the side of the blog, even though it changes from time to time.

Like when I added that 'Michael's Brain' pulldown, and included a piece of an MRI image:

Michael's Brain (internal view)

The text atop the image is:

A nice FLAIR (FLuid Attenuated Inversion Recovery) view from the not-too-distant past. Every abonrmality you can see on this scan (and there is more than one!) is asymptomatic at present.

Anyway, a few people had noticed this and asked me what are the abnormalities I was talking about. :-)

There are two different problems in this scan.

The first one is those white spots spread diffusely through the whole image. That is MS stuff. I did not put up the T2 images with Gadolinium contrast, but if I did you would be able to see that these lesions, which do not enhance, are currently asymptomatic.

If you buy that theory about us only using 10% of our brains, then these areas would be part of that 90% I am not using (alternately if you buy the theory Douglas Adams suggested, these would be the areas in which you would store penguins. In that case, Opus is one of those bigger spots on the left!).

The other problem is that dark black spot all the way at the bottom, a little off of the midline. This spot is a small arteriovenous malformation (AVM), probably congenital, and definitely asymptomatic. It has been on every one of my scans since the first one back in 1991 and has never changed in size or any other characteristics. As a rule if they are asymptomatic and unchanging then one just leaves them alone so as not to anger the AVM. Just one of those little oddities that probably would never have been noticed had I not been getting MRIs for unrelated reasons....

Anyway, that is just another view on my brain, the blog and its posts being a slightly different view. You could suggest that both views show abnormalities, and I won't argue the point. Though I think the various abnormalities are all unrelated. :-)

Hope you enjoyed the alternate view of my brain. I may add some more images or change them, from time to time if the mood strikes me....

For other MS news, I just recently had my fifth Novantrone infusion, and like last time have had nausea since the infusion happened. Not too terribly fun, but I guess I'll live. It is kind of annoying though, and the Zofran is not completely taking care of it. If it keeps happening maybe I'll call my neurologist and let her know....

Stuart Dootson on 14 Sep 2006 3:58 AM:

Mmmmm - nausea's bad - it's the symptom of migraines that really hits me worst. Still - at least my migraine medication does alleviate it, unlike your stuff :-(

Zach on 14 Sep 2006 11:21 AM:

Hope the nausea passes soon.


brent (incrediculous AT gmail.com) on 17 Sep 2006 5:38 PM:

Hi Michael.

I saw your reply post.  Thanks.

You may be interested to know that nothing showed up on my MRI in December, shortly after I emailed you.  So, technically I don't have multiple sclerosis... or at least not a diagnosis.

Most of my December symptoms cleared up in January  It certainly fits that it was an exacerbation which left just a few lingering problems -- thick tremor in my tongue and pinky fingers being one of them.

Since then I've also seen an optho-neurologist for additional MRIs, and they have come up clean as well.  I have a lot of crazy dots, sparks and squigglies in my vision.  They only appear on bright, uniformly-colored backgrounds, like a bright blue sky or computer monitor.

Strange sensations or twinges come and go throughout the day in my limbs.  It's not debilitating.  Just, annoying.  It's mostly the thought that I *may* not be doing OK in the future that torments me the most.

I feel like I'm in limbo, and we're just waiting for something to pop-up on an MRI.   Maybe I'll stay like this for the rest of my life, which wouldn't be so bad at all, but it's frightening not knowing what's ahead.

I've read that very few MS cases don't present lesions on MRIs at onset.  So maybe it's not MS after all.  At least I can hope.

Thanks again,


Michael S. Kaplan on 17 Sep 2006 8:34 PM:

Hi Brent,

It really is not bad news, though I understand how frustrating it can be wondering what is going on. Having experienced both the uncertainly of the lack of a diagnosis and the certainty of having MS, I can tell you that the former seems worse until the latter happens....

But with that said, even if it is MS, as negative MRI is an excellent sign since it means very little progression of the disease. That is a good thing, any way you slice it.

But my advice would be to keep on the doctors in a calm, rational way to get a diagnosis. You don't need to be frantic (they have ruled out the really frantic life threatening stuff already), but if you are calm and persistent it will keep you interested in wanting to know what it is so you can make progress Z(every negative test is one less thing it can be!).

One thing I would recommend -- get your films of the MRI (on computer seems to be cheaper in most hospitals and even free in some). You never know when having comparative studies can be helpful down the road, and they do not keep the scans forever....

Good luck in any case, and definitely hang in there! :-)

mdmhvonpa on 3 Oct 2006 3:42 PM:

Hey, nice image reproduction. I still have the old celluloid prints from back in the last century ... none of the nice new digital prints. Of course, most of my scars are in the spine and Opical nerve. Had my whole durned body scaned. Oddly enough, I got my prints for free.

Michael S. Kaplan on 4 Oct 2006 12:05 PM:

I think they only started charging more once the low-cost option involving CDs was made available....

Tanya on 7 Oct 2006 10:43 AM:

My 29 year-old son thinks I am an old fogey (may be right) cuz I  have never posted on a blog.  You are the first. Sorry about the Novatrone nausea. I hope it stops.

My MRI has only 2 small lesions on the brain. I can only assume that my spine sports many more 'cuz I have never had a spinal MRI and now have a baclofen pump so am no longer a candidate.

I didn't realize that one could get a copy of their MRI on the computer so think I will ask about that. BTW, I can tell from your Mri that you are a really nice guy.

For Brent; the limbo thing sucks.  I used to facilitate a group for newly-diagnosed and my opinion is that having a definite diagnosis helps 'cuz it validates what you are going through.  You are not a hypochrondiac but have a real reason for the stuff happening to you!

Well, I will not fill up your whole blog with my rambling; thanks for the "first time" experience.

Michael S. Kaplan on 7 Oct 2006 2:24 PM:

Hi Tanya,

That doesn't make you an old fogey, believe me. Feel free to comment (here or really anywhere) if you see something that you want to say something about....

Though I wonder how you could tell I was a nice guy from my MRI? :-)

lorraine hawks on 22 Oct 2006 7:51 PM:

hello i have rr ms 5 years dx.

Michael S. Kaplan on 22 Oct 2006 7:57 PM:

Hi Lorraine,

Any symptoms right now? And (out of curiousity) may I ask how old you are?

Vikki on 10 Nov 2008 2:37 AM:

Hey there, I've been googling for ms information since the onset of some pretty intense symtoms.. I'll spare you the details. I had an mri last week and see a neurologist on Tuesday (day after tomorrow) and it seems from the report and my films that I do have ms.  I'd like to keep in touch :)

Take care.

Michael S. Kaplan on 10 Nov 2008 7:18 AM:

Hi Vikki, Definitely, let's keep in touch!

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