Hello doctor, I got MRI of my body done eight years back. The results were good. The radiologist did not find anything clinical relevant. The past three months I suffered from several weird conditions. Ringing in the ears, while the tones shift in frequency (I guess this is not an usual aspect of tinnitus), sometime seeing stars or flashes and headaches. I decided to make a new MRI of my brain, to make sure everything is normal. The new MRI shows some differences compared to the one made earlier. I was pretty shocked when I saw the images. In regard of a second opinion, I would like some more information about abnormalities found in the recent MRI, just to get as much information as possible about my brains health. I would like to ask you a few questions regarding the images from my latest MRI. 1. Could you give your opinion about the images and possible abnormalities? 2. Could you explain about the cortexes where the possible abnormalities are in? 3. Is the area around my mouth or sinuses in the recent MRI looking normal? 4. What is the bright spot in picture 13a? 5. What is the bright straight line at the hight of my nose at picture 11? Cancer appears in the family and I just wanted to be sure. I do not have dental implants. Do you notice anything strange around the mouth area?
Hello.  After having gone through the images, my first message to you is: Nothing to worry (attachment removed to protect patient identity). Absolutely nothing to worry or simply think about. Just wash them out of your mind. All you need to do is lead a healthy life with healthy habits. My findings in your recent MRI: Prominent cisterna magna aka mega cisterna magna, tiny T2-bright spot in the right lentiform nucleus, likely representing an old tiny infarct. Retention cyst in right maxillary sinus. None of these findings have any clinical significance, nor do they have any significant effect on your living or longevity. The old tiny infarct is tiny enough that you never knew that it was there. However, if it were larger, it could have troubled your living, so it is something to remain conscious about. Mega cisterna magna (enlarged CSF space behind cerebellum) occurs in <1% of people and is mostly considered a harmless normal variant. However, people with MCM are often considered to be prone to infarcts, so it would be advisable that you avoid or control other factors that also cause infarcts, especially when there is already an infarct (thankfully tiny, though) like controlling hypertension / diabetes (if you have), avoiding smoking and alcohol, etc. Retention cyst is a fluid-containing pouch that can develop in the nasal sinuses. It is harmless, in fact not worth mentioning. Your mouth and sinuses do look normal, except for the retention cyst in the right maxillary sinus. Unfortunately, none of your files is labeled 13A. However, there is a bright spot - it is the retention cyst in the right maxillary sinus. The bright line is an artifact generated by the machine during imaging or image processing. Regarding your worries over familial cancer, there is nothing your brain MRI to increase your worries. Perhaps regular follow-up is sufficient. I asked about dental implants because without the DICOM images, I was a bit confused whether the bright spot (representing the retention cyst) was in the sinus or in the gums or teeth. Now, I am confirmed that it is in the sinus and your teeth sockets are normal.