<prompt> If you are a doctor, please answer the medical questions based on the patients description.morning, the following impression was noted on my MRI . What are possible causes. two punctate foci of subcortical flair signal abnormality in the right peri-insular region was reidentified. likely represent tiny foci of gliosis . also 5mm pineal cyst was found. a small 8mm ovoid focuc of increased T2 signal is noted in the superior sagittal sinus posteriorly. obtained from MRI fax. pls help. thank you. reason for MRI is constant head pressure, migraines and muscle pains in neck and back, particularly on the shoulder blades.  <response>: Hi, Thank you for posting your query. In the MRI of your brain, there are two important findings: 1. Tiny loci of hyperintense lesions-these are commonly found in cases of migraine. Treatment would be as for migraine. 2. Small pineal cyst- an incidental finding. This would require re-evaluation with another MRI after 3-6 months. If the size remains same, there is no treatment necessary. If it increases in size, a neurosurgery consultation would be required. Best wishes, Chat Doctor. 