The ventricles in your brain are interconnected cavities that produce, distribute, move, and store spinal fluid. When lesions form along these ventricles, they create finger-like shapes that can be seen on an MRI.

These shapes are called Dawson’s fingers. The condition was named after Dr. James Dawson, a Scottish pathologist who first identified these elongated lesions in the early part of the 20th century.

Dawson’s fingers are often linked to multiple sclerosis. However, there are other neurological conditions that these lesions may indicate.

This article will review what Dawson’s fingers look like on an MRI, their connection to multiple sclerosis, and other neurological disorders that their presence may indicate.

On an MRI, Dawson’s fingers look like bright white, elongated shapes extending at right angles from the ventricles of the brain. The size of the lesions vary depending on how advanced the condition is.

The following gallery of MRI images shows what Dawson’s fingers look like in the brain.

The nerve fibers in your brain and spinal cord are wrapped in a protective coating of lipids and proteins called the “myelin sheath.” If you have multiple sclerosis (MS), your body’s immune system mistakenly attacks healthy tissue around the central nervous system, triggering inflammation that damages the myelin.

Lesions — also called “plaques” — form in the damaged areas of myelin. These lesions disrupt the flow of signals along the nerve pathways, interfering with the nerves’ ability to communicate and function.

As multiple sclerosis progresses, additional damage to the myelin sheath causes more lesions to form. This in turn causes additional disruption of signal movement along your nerves. The symptoms of MS depend on what nerve fibers are most affected by this damage.

Diagnosing and tracking the progression of MS

Imaging tests, such as MRI scans, are often used to diagnose and monitor the progression of multiple sclerosis. The images seen in an MRI scan provide a visual representation of the damage to nerve fibers.

While Dawson’s fingers are a frequent finding in people with multiple sclerosis, there are other conditions where this type of imaging can also appear.

When diagnosing MS, doctors use other tests such as neurological exams and cerebrospinal fluid testing to rule out other conditions that may have similar symptoms.

Not everyone who has Dawson’s fingers has multiple sclerosis, but these finger-like markings on brain imaging are usually a red flag for additional examination.

Multiple sclerosis is often the cause when these images are seen on MRI, but there are other conditions they could be linked to, as well. These include:

People who have Dawson’s fingers appear on their MRI — whether they have been diagnosed with multiple sclerosis or not — also appear to be at a higher risk of conditions like:

  • cerebral microbleeds
  • white matter demyelination
  • inflammation
  • brain atrophy

Do Dawson’s fingers ever go away?

It’s possible for brain lesions to go away, particularly if they’ve been caused by a brain injury.

In people with MS, myelin in the damaged areas can be repaired by the body itself to some extent. This is known as “remyelination.” However, myelin repair isn’t perfect — you may gain back some functionality or none at all.

What percent of people with MS have Dawson’s fingers?

A 2014 study found that Dawson’s fingers occurred in a majority (between 77.5 and 82.5 percent) — but not all — of participants with MS.

According to the Shepherd Center, approximately five percent of people with confirmed MS don’t initially have brain lesions.

Is it possible to prevent or slow down the formation of MS lesions on your brain or spinal cord?

Yes. Newer generation medications for MS are designed to slow down myelin damage. Talk to your doctor about disease-modifying therapies (DMTs) used to treat MS.

Your doctor can also refer you to clinical trials that are testing new therapies such as ibudilast, clemastine fumarate, and hematopoietic stem cell transplantation (HSCT).

Can the location of brain lesions determine what neurological symptoms you will experience?

Yes. Certain symptoms are specific to where the brain lesions are found:

Front lobe Temporal lobeParietal lobeOccipital lobe
loss of smellemotion and behavioral changesloss of touchvision changes
impaired speechproblems with smell, taste, and hearinginability to identify objects placed in hand
loss of motor activityvision problemsweakening of language skills
behavioral changesforgetfulness, inability to focus

How does MS affect your fingers?

A primary symptom of MS is the loss of dexterity — often accompanied by pain, numbness, and tingling — in the hands and fingers. Fine motor skills like those used for writing, eating with utensils, or picking up objects become more difficult as the condition progresses.

The term “Dawson’s fingers” however, is a term for lesions in the brain. It does not refer to a loss of finger coordination in MS.

Dawson’s fingers are not a symptom, but rather a sign of some degree of neurologic disease. Although Dawson’s fingers appear most often in people with multiple sclerosis, it doesn’t appear in every case of MS, and people with other conditions could have this damage, too.

Your doctor may perform imaging studies of your brain to help diagnose a variety of neurological conditions.

Finding Dawson’s fingers on an MRI could lead to suspicion of an MS diagnosis, but other testing and examinations should be factored into a final diagnosis.