Brain Lesions On Mri

Gamma Knife offers new treatment possibilities

Following the diagnosis earlier this year that her lung cancer had metastasized to her brain, the 64-year-old Long Branch resident underwent a procedure called tomotherapy radiosurgery at Monmouth Medical Center in Long Branch in March, only to find out that another small tumor had appeared. But the treatment offered to her at Monmouth Medical Center was significantly different this time around — a swift, painless procedure that was able to eradicate the lesion in her brain with near-absolute certainly. What changed between March and June 2011 at Monmouth Medical Center that so radically improved the surgical outcome and comfort level for Lena and other patients? The hospital’s April 2011 acquisition of the Gamma Knife, an advanced radiosurgery technology that can treat benign and malignant brain tumors, vascular malformations, trigeminal neuralgia, and other brain-induced conditions such as tremors, movement disorders and pain problems. The Gamma Knife is one of the oldest radiosurgery devices available to the medical community. Invented in 1967 by Swedish neurosurgeon Lars Leksell and successfully treating more than 500,000 patients worldwide since then, “the Gamma Knife has been considered the ‘gold standard’ of stereotactic radiosurgery for brain lesions,” said Dr. Sang Sim, radiation oncologist and co-medical director of The Gamma Knife Center at Monmouth Medical Center. Similar in appearance to an MRI machine, the Gamma Knife’s ability to obliterate brain lesions is a function of the machine’s core, which contains radioactive cobalt dispensed in the form of gamma rays — super high-energy rays that lie beyond X-rays on the radioactive spectrum and are created by the decay of Cobalt 60, a synthetic radioactive isotope of cobalt.

“With other, less accurate technologies, you have to treat a larger area with radiation in order to ensure you’re addressing the affected area,” Sim said. “This approach kills the bad tissue but also exposes surrounding good tissue to radiation, which can increase complications and trigger side effects such as hair loss, fatigue, brain swelling, and neurocognitive consequences. “With the Gamma Knife, high-tech computer imaging allows us to create a customized ‘plan’ for each patient and treat an exact location,” he said.

MS Lesions – How to Detect Lesions on the Brain

Lesions are basically scars caused by any number of things; trauma, illness, or infection, just to name a few. MS lesions are scars caused by the demyelination of nerves in the spinal cord and brain. As more damage occurs, the number of lesions increases, which tends to be the case as Multiple Sclerosis advances.

Doctors are able to determine how much damage is done by the number and size of the lesions seen. MRI pictures of MS lesions help a doctor get a better idea of how much demyelination has already occurred and which lesions have reactivated. Of course there are always instances where nerves have been damaged and then remyelinated themselves. When this happens, the lesion may not show up at all.

The effects of MS Lesions on Brain

An abundance of lesions on the brain can sometimes cause certain symptoms to arise. Brain lesions cause changes in the thought process, depression, impaired speech, a loss of coordination, and a loss in judgment. A combination of these effects or only one may occur in MS patients. The reason MS lesions on the brain can cause these physical alterations to occur is from the demyelination of nerves.

Not all signs and symptoms of MS are connected to the lesions. For example, fatigue is associated with MS, but it has nothing to do with the amount of lesions appearing on the brain during an MRI scan. In fact, the current MRI MS lesions images will often show scarring which don’t have anything to with symptoms present during the time of the scan.

 

How MS Lesions on MRI Scans are Deciphered

When an MRI of MS lesions is taken, the scars could already be relatively old. The age of the lesion can sometimes be determined by how well they show up on the scan. There are always scars that don’t appear, no matter how old they are and also active lesions won’t generally show up because not enough demyelination has taken place.

The brainstem is where symptomatic lesions are found and they will show up as very bright areas on an MRI scan. Older areas where lesions have been reabsorbed will appear black. These dark spots appear when MS has progressed to an advance stage. Usually two MRIs are taken and compared to detect MS lesions. After the first regular scan is complete, an MRI contrast is taken. As these two are compared, old lesions that have been reactivated will be noticeable.

The Neurobiology of Multiple Sclerosis

MRI can also be a tool for prognostic purposes. At baseline, 73% of patients had lesions on T2-weighted fast spin-echo (FSE) brain images and 42% had ...

Oxford Handbook of Clinical Medicine

... must conform to MS Typical disseminated lesions on MRI or +ve CSF and 32 MRI ... ie: › MRI evidence of 39 T2 brain lesions; or 2 or more cord lesions; ...

Handbook of Neurosurgery

A. 2 9 T2WI lesions on MRI or B. a2 lesions in spinal cord or C. 4-8 brain + 1 spinal cord lesion or D. abnormal VEPA + (4-8 brain le sions or< 4 brain ...

Rehabilitation for traumatic brain injury

Levin et al. inferred that the presence of a brain lesion on MRI during the first week after injury was a risk factor for residual cognitive impairment but ...

Interferon therapy of multiple sclerosis

First, the influx was still detected in 30% of the clinically stable MS patients who lacked gadolinum-enhancing brain MRI lesions. The amount of gadolinium ...