Midline shift describes the situation where the midline of the intracranial anatomy is no longer in the midline and is the result of pushing or pulling forces within either side of the intracranial compartment see Figure 1. Before the advent of cross sectional imaging, midline shift was assessed by displacement of the calcified pineal gland on a frontal radiograph of the skull 2.
Midline shift is measured in millimeters, as the perpendicular distance between a midline structure usually the septum pellucidum and a line designated the midline. The midline is assumed to be coplanar with falx cerebri, and is best represented as a line drawn between the anterior and posterior attachments of the falx to the inner table of the skull. Care must be taken if there is existing asymmetry of the ventricles or the falx.
If the falx is not straight, a line between the free edges of the anterior and posterior falx can be used instead. The superior sagittal sinus can also be used to indicate the posterior falcine attachment provided it is truly midline and not coursing to one side as is seen sometimes with a dominant transverse sinus. Midline shift typically results from unilateral frontal, parietal, or temporal lobe mass effect displacing the cingulate gyrus beneath the free edge of the falx cerebri and is associated with a number of neurological complications.
Midline shift sign is considered ominous because it is commonly associated with a distortion of the brain stem that can cause serious dysfunction evidenced by abnormal posturing and failure of the pupils to constrict in response to light 4.
Midline shift is often associated with high intracranial pressure ICPwhich can be life-threatening 5. In fact, midline shift is a measure of intracranial pressure ICP ; presence of midline shift is an indication of raised intracranial pressure 6. The displacement of brain structures described above illustrates the Monro-Kellie doctrine, which states that in an adult the cranial volume is a constant.
please explain the MRI results of my brain
The cranial contents consist primarily of brain, cerebrospinal fluid CSF and blood vessels. If a mass such as a hematoma, tumor or edema develops, these elements must shift to accommodate the mass. Since the cranial volume is a constant, part of the cranial contents will herniate through the tentorial incisura to make room for the mass. The opposite occurs in a patient with loss of brain mass, such as occurs after a stroke, wherein the CSF spaces often enlarge to fill the void.
Footnote: 80 year old female with altered conscious state following fall. Patient on anticoagulation warfarin for atrial fibrillation. The huge acute subdural overlying the right cerebral hemisphere as well as filling the floor of the middle cranial fossa and tracking along the posterior aspect of the falx blue arrowresults in marked mass effect and midline shift red. There is marked uncal herniation yellow with significant distortion of the midbrain blue dotted line.
This case illustrates just how large acute subdural hemorrhages can be, and that with prompt surgery patients can be saved. In this case the degree of midline shift was such that a right sided anterior cerebral artery infarct developed.
The ideal midline C is determined as the line between the most anterior and posterior part of the falx cerebri. Symptoms of elevated intracranial hypertension are primarily derived from neurological irritation, compression, or displacement and papilledema. Non-specific headaches are recorded in almost all cases and are likely mediated via the pain fibers of the trigeminal nerve in the dura and blood vessels of the brain.
Pain is generally diffuse and worse in the mornings with exacerbation by the Valsalva maneuver. Nausea and vomiting are common presentations of elevated intracranial pressure.
Patients can present with double vision most frequently with horizontal diplopia associated with CN VI palsy from compression. Transient visual abnormalities occur frequently, often described as a gradual dimming of vision in one or both of the eyes. Visual abnormalities worsen with changes in posture. Peripheral visual loss may be reported and most commonly begins in the nasal inferior quadrant with subsequent loss of the central visual field.
Alterations in visual acuity with blurring or distortion may occur. Variable degrees of loss of color distinction may occur. In more severe or chronic cases, a sudden visual loss can occur due to intraocular hemorrhage. Tinnitus with a pulsing rhythm exacerbated by supine or bending positions and Valsalva maneuver can occur.
Radicular pain, numbness, or paresthesias are possible and most commonly associated with localized compression or possible herniation of the brain.Dictionary entry overview: What does abnormality mean?
An abnormal physical condition resulting from defective genes or developmental deficiencies. A group of acute myeloid leukemias characterized by recurrent genetic abnormalitiesmainly balanced translocations.
There is no history of prior cytotoxic therapy for an unrelated disorder, and there is absence of the cytogenetic abnormalities that are present in acute myeloid leukemia with recurrent genetic abnormalities. Acute myeloid leukemia characterized by the presence of abnormal bone marrow eosinophils and the characteristic cytogenetic abnormality t 16;16 p Acute Myeloid Leukemia with t 16;16 p This abnormality can be either heritable or occur somatically.
An acute myeloid leukemia with recurrent genetic abnormalities occurring in adults. Hypercortisolism is the most common hormonal abnormality observed in this cancer; patients may also present with virilism or Cushing's syndrome. Acute myeloid leukemia characterized by the presence of abnormal bone marrow eosinophils and the characteristic cytogenetic abnormality inv 16 p Acute Myeloid Leukemia with inv 16 p An abnormality in the formation or distribution of pigment, especially in the skin.
An abnormality in the position of the fetus during the labor and delivery process.
Double-click any word on the page to look it up in the dictionary. Acute Myeloid Leukemia with Myelodysplasia-Related Changes, NCI Thesaurus Acute myeloid leukemia characterized by the presence of abnormal bone marrow eosinophils and the characteristic cytogenetic abnormality t 16;16 p Adult Acute Myeloid Leukemia with Recurrent Genetic Abnormalities, NCI Thesaurus Hypercortisolism is the most common hormonal abnormality observed in this cancer; patients may also present with virilism or Cushing's syndrome.
Acute Myeloid Leukemia with Myelodysplasia-Related Changes, NCI Thesaurus Acute myeloid leukemia characterized by the presence of abnormal bone marrow eosinophils and the characteristic cytogenetic abnormality inv 16 p Abnormal Pigmentation, NCI Thesaurus An abnormality in the position of the fetus during the labor and delivery process. English learning courses. About Practical English. About Telephone English.
About Accounting English. Free English Language Dictionary. British and American English pronunciation. AudioEnglish DefinitionsBy proceeding, I accept the Terms and Conditions. No acute intracranial process. View answer. I had an MRI of my brain done because of a diagnosis of dementia. I'm 69 and have CLL. The findings say 1. Chronic microvascular ischemic disease The visualized cavernous sinuses Differential considerations include sequelae of migraines, demyelinating or other inflammatory The uncinate processes are correctly oriented.
There is a moderate sized right Haller Recent blood test revealed lipase level ofnormal amylase level. I also have experienced acute pain just behind and left of xyphoid process that radiates to the back. Painful to pressure placed We took her for an MRI yesterday and it said Acute intracranial abnormality No, it means there is no tumour or infection in brain apart from normal changes seen in a 65 year old male.
So you do not have dementia. These are normal black images of mri as flowing blood is not deteced in mri. Normally found so dont worry. Your sinus thickening means you are having chronic sinusitis. So contact a doctor. It is easily treatable.
So dont If it is the first time you have had a headache like this, you should go to a hospital emergency. This could be due to many things: acute glaucoma, beginning of cluster headache or first migraine attack, cavernous Coronavirus Doctor Consultation Are you a Doctor?
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What does this mean? Impression from the Brain Scan: No acute intracranial abnormality is noted. Multiple T2 and FLAIR hyperintense foci in bilateral periventricular white matter as described above likely consistent with demyelinating disease such as MS.
No abnormal enhancement of these presumed demyelinating plaques is noted after administration of intravenous gadolinium. These findings can be seen with the given history of multiple sclerosis, however they can also be seen in the setting of transverse myelitis or ADEM, though less likely. Clinical correlation is recommended.
Hello chadntx and welcome to NeuroTalk. Your Neurologist is the best person to explain your MRI results. Your MRI results appear to support your diagnosis. Lesions can show up anywhere within the CNS. My Mood:. Chad, As was said above, the best person to ask is your neurologist. Any opinions you get from here are worth exactly what you paid for them.
With that said, here is what I see in the results you posted. The "hyperintense foci" they describe is just a fancy word for a bright spot on the scan.
Bright spots on those types of MRI scans can be evidence of some process that is removing the protective coating myelin from the surface of the nerve tissue in your brain and spine. That is called dymelination and MS is a disease that can cause demyelination in the brain and spine.
There are other processes and diseases that can cause it too, which is why the radiologist recommends "clinical correlation", which is simply matching the possible causes to your symptoms and other test results to determine what might explain the bright spots in the brain also sometimes called lesions or plaques.By proceeding, I accept the Terms and Conditions.
No acute intracranial process. View answer. I had an MRI of my brain done because of a diagnosis of dementia. I'm 69 and have CLL. The findings say 1. Chronic microvascular ischemic disease The visualized cavernous sinuses Differential considerations include sequelae of migraines, demyelinating or other inflammatory The uncinate processes are correctly oriented. There is a moderate sized right Haller Recent blood test revealed lipase level ofnormal amylase level.
I also have experienced acute pain just behind and left of xyphoid process that radiates to the back. Painful to pressure placed We took her for an MRI yesterday and it said Acute intracranial abnormality No, it means there is no tumour or infection in brain apart from normal changes seen in a 65 year old male.
So you do not have dementia. These are normal black images of mri as flowing blood is not deteced in mri.Heart Sounds - S1 S2 S3 S4 and Murmurs Nursing Assessment
Normally found so dont worry. Your sinus thickening means you are having chronic sinusitis. So contact a doctor. It is easily treatable.I think you need to ask your doctor. But in general 'acute' means sudden. In medicine it typically means the sudden onset of illness or symptoms as opposed to gradual or chronic on going. Acute intracranial process is a term for many diagnoses. It basically means there is pressure caused by a number of things which the neurologist can futher define for you.
The congestion of the left nasal turbinates means that at the time of the MRI, you had congestion in that area. The turbinates can become congested without you even realizing it. If one is congested, the other will be clear. This process occurs off and on, self-regulating most of the time. In cases of marked swelling, you will notice a definate "clog" on one side or the other and if severe, can lead to the classic "sinus infection".
There are so many more factors that a doctor will rely on in your diagnosis. Your general medical history, your demographics, the onset and duration of your headaches and all accompanying symptoms. Hope this helps in general. Emory Traylor. The doctor checked my xrays and gave me that information. Answer Save.
Lydia Lv 4. This Site Might Help You. RE: What does no acute process means? How do you think about the answers? You can sign in to vote the answer.
There is no associated enhancement of these lesions. These are non specific but probably reflect microangiopathic ischemic changes. There is no hydrocephalus. No abnormal extra-axial fluid collections are noted.
No areas of abnormal enhancement are seen. Normal flow-voids are maintained at the skull base. This visualized paranasal sinuses and mastoid air cells are clear. Impression: 1. Age-appropriate celebral atrophy. Nonspecific subcortical white matter signal abnormality, although is probably due to microangiopathic ischemic changes. No acute intracranial abnormality. I am 65 years old and has headache at my left front side of head for the last two months. I am ok when I lay down.
The MRI was done about 15 days ago. Answer Question. Read 2 Responses. Follow - 3. Dr Sharma. Hi there. It is important to make note that white matter lesions on a brain mri does not necessarily mean Multiple sclerosis.
White matter lesions can be seen in various conditions. These represent micro vascular ischemic changes in the brain hence these white matter abnormalities on mri are common in patients who have microvascular and macro vascular risk factors like history of hypertension, diabetes and high cholesterol.
White matter signal changes on MRI are seen in infectious and other inflammatory conditions and migraine headaches. These white matter signal changes on brain mri need to be correlated to the history, clinical examination and other ancillary investigations. Your doctor will need to investigate you for multiple sclerosis where the disease phase is characterized by active phase and remissions.