Non-Specific White Matter Lesions on MRI Brain

This condition is treated in the Neurology clinic.

Pre-referral work-up

History

These are not infrequently reported on MRI scans done for other reasons.

Most often they are not of clinical significance rather represent an incidental finding typically in patients with multiple cardiovascular risk factors or migraine.

Enquire in relation to:

• Symptoms and signs of cerebral vasculitis; worsening headache, focal neurology, fever, rash, impaired conscious state
• Previous symptoms or signs suggestive of a demyelinating event (optic neuritis, hemi-sensory change, hemiparesis, transverse myelitis etc.)

Tests

• Fasting blood glucose, blood lipid profile
• Consider: CRP, ESR, vasculitic screen

Interim/GP management

To refer a patient with this condition, please see the Neurology clinic page for the full referral process and templates.

• Reassure the patient if you suspect that this is an incidental finding
• If you are suspicious of more serious underlying pathology, consider discussion with the on-call Neurologist or Neurology Registrar.
• Modify vascular risk factors if found and consider low-dose aspirin in these patients

For more information please see the HealthPathways Tasmania website.

Clinic appointments

? Red location flags are clinical indicators of possible serious underlying conditions requiring further medical intervention. They may or may not indicate an emergency.

Urgent (Category 1)

? Symptoms or signs suggestive of cerebral vasculitis or demyelination.

We will endeavour to see these patients within two weeks.

Urgent referrals should be accompanied by a phone call, as per below:

• Contact the Neurology Registrar directly within hours via the RHH switchboard Phone: (03) 6166 8308

Routine (Category 3)

Suspected incidental finding

Next available appointment

Availability

North

Launceston General Hospital
Level 3 - Specialist Clinics

Phone: 1300 977 694
Fax: 03 6777 5227

North West

Unavailable.

South

Wellington Clinics
Phone: 03 6166 0000
Fax: 03 6173 0491