Non-Specific White Matter Lesions on MRI Brain

Availability

North South North West Statewide

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 Tasmanian Health Pathways website.

Urgent / category 1

Symptoms or signs suggestive of cerebral vasculitis or demyelination.

Routine / category 3

Suspected incidental finding

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

Emergency:

Proceed to Emergency Department (ED).
LGH ED Reception  – Phone: (03) 6777 6405  Fax: (03) 6777 5201
MCH ED* – Phone: (03) 6478 5120  Fax: (03) 6441 5923
NWRH ED* – Phone: (03) 6493 6351 Fax: (03) 6464 1926
RHH ED Reception – Phone: (03) 6166 6100  Fax: (03) 6173 0489

Advice for medical practitioners can be given by the Medical Officer In Charge (MOIC) - see HealthPathways Tasmania for contact information.
*MCH and NWRH MOICs request GPs call them prior to referring a patient to ensure the patient is being sent appropriately to a safe destination.

Urgent:

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
Semi-urgent:
Routine:

Next available appointment