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Me Lose BRAIN? Uh-Oh! (The Incredible Shrinking Brain!)

Posted Nov 12 2010 3:26pm

Well, spank my hiney with a leather strap and call me “Pinky.”  Just got my medical reports from my experience in the clinical trial at Vanderbilt, and just when you think you’ve learned everything there is to learn about what happened to you… SURPRISE!

Back in 2007 coming up on four years ago the last I ever had said I had “mild, diffuse brain .”  This is the MRI I described, beginning on page 80 of “No Doorway Wide Enough” , the day I had the bone markers that they use as a platform for the stereotactic frame drilled into my skull.

My nurse-of-the-day came into the room and said radiology called.  They were sending someone to take me back down for an MRI.

“I thought I was too fat,” I said.

“They’re going to try it anyway,” she said with a shrug.

Moments later, two young ladies arrived with a gurney.  “Where’s your hospital gown?” one asked, no doubt puzzled by the fact that I was wearing a black t-shirt, green shorts and sneakers.

“Don’t have one,” I said.  “And this is silly.  I can walk down there.”

“No, this is procedure,” she said.

“Fine,” I said as I hopped onto the rolling bed.  I pulled the sheet up over my face and said, “Let’s go.”

“You’re gonna scare everyone,” my driver said, pulling the sheet down.  “Stop that.”

We went back the way we came… through the tunnel separating the main hospital from the Medical Center North.  There in the MRI lab was the guy from earlier – the one with the tape measure.

“I thought I was too fat,” I said.

“So did I,” he said, “but we’re gonna try anyway.”

He rolled the gurney into the MRI room and I got on the table.  He asked me to lay down with the back of my head in the coil they use to get better pictures of the brain.  My head didn’t fit.  It’s a large head.  What can I say?

I sat up so they could change the coil, and noticed something trickling into my right ear.

“How did I get water on me?” I wondered as I wiped my ear.  My right hand came back with my index and middle fingers soaked in blood.

“Fellas, I seem to be bleeding here,” I said as calmly as a guy with a bleeding head can say.”  Turns out I bumped one of my new scars on the skull coil.  As it was still numb from anesthesia, I didn’t feel it.

They put a gauze and tape over the incision and tried another coil.  This one was even smaller… it was like trying to put 10 pounds of cheddar into a box meant for five pounds.  They decided to go with a larger coil.  This one fit tightly, like a football helmet, but it did the trick.

“All right,” the tech said, “we’re going to strap your arms to your side and slide you into the tube and see if we can get you in there.  Pull your arms in as tight as you can.”

I did as directed and they slid me into the tube.  My arms and elbows pressed into my rib cage, but they were able to get my head where they needed it.  After nearly a half hour they pulled me out of the tube, injected me with a contrast agent, and stuffed me back inside.

Another 12 minutes and they were done.  I was treated to another gurney ride back to my room, and never was I so glad to see a hospital lunch as I was when they brought it in to me.

Now, I really do NOT recall anyone telling me ANYTHING about the results of the MRI.  So I assumed everything was hunky dory and that I had a fat, jolly brain filling up my big, bald head.

What they didn’t tell me was, according to their MRI…

But it is a progressive condition, so one can only assume (I can’t have any more MRI’s the magnet would create an interesting phenomenon by which all the metal in my skull and brain and chest would be sucked right out of my body, out of my head, where they would stick to the big magnet) that there’s been more since 2007.

Here’s what the MRI report from 6/5/2007 says:

FINDINGS: There is some mild atrophy of the brain.  Normal arterial flow voids are present.  There is no evidence of abnormal extraaxial fluid collection or .  No abnormal areas of contract enhancement are evident.

IMPRESSION:  1.  Limited MR done prior to deep brain stimulus placement.  2.  Diffuse atrophy

“Diffuse Brain Atrophy” is the sort of thing that happens to boxers (fighters, not the dog breed), not (at that time) 52-year old civil servants.  But, from what I can find in the literature , some brain atrophy falls in line with my particular brand of Parkinson’s the “rigid-akinetic” or “RA” type, moreso than the “tremor” or “T” type.

No significant differences were found with respect to the severity of diffuse brain atrophy. However, a trend was found for brain atrophy to be more likely associated with the RA-type than with the T-type.

And it explains why my is more affected than my long term.

These have consistently shown that diffuse brain atrophy is characterised by a memory deficit in which remote memories for facts and events are relatively well preserved (Sagar et al, 1988; Beatty et al, 1988; Kopelman, 1989).

The literature seems to suggest (if I’m reading it correctly, who the hell knows with my tiny, little brain) that this is indicative with Parkinson’s Disease Dementia.

An early study of PDD did not find any particular pattern of abnormality on MRI ( Huber et al., 1989 ). In contrast, the annual rate of brain atrophy has recently been correlated with global cognitive decline ( Hu et al., 2001 ), supported by findings of diffuse cerebral atrophy and basal ganglia degeneration in patients with cognitive impairment.

We hypothesized that brain atrophy would be greater in PDD than in Parkinson’s disease, and that the pattern would be more similar to that seen in DLB () than in .

Whatever.  The definition of “diffuse brain atrophy” is:

A form of dementia caused by destruction (atrophy) of the of the brain. This condition leads to the progressive deterioration of mental functioning. Incidence: 9 in 10,000 people in the general population.

So, it’s like I’m 900 in a million.  (See?  That part still works.)

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