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MRI of the Brain without Contrast
Technique: Multiplanar, multisequence MR imaging of the brain without contrast.
Findings: The ventricles and sulci are midly prominent for the patient's age, suggesting mild diffuse cerebral volume loss. There is a small focal area of abnormal increased T2 signal in the medial aspect of the anterior right temporal lobe. There is no diffusion restriction in this area or anywhere else in the brain. No susceptibility is seen to suggest blood or blood products. On T1-weighted imaging, this small focus of abnormal signal is slightly hypointense. This small lesion measures approximately 5 mm in diameter. No other white matter or gray matter lesions are identified. The orbits and optic chiasm are normal in appearance. The basilar cisterns are patent. Flow is seen in the intracranial vessels at the circle of Willis. No extra-axial fluid collection is seen. The cerebellopontine angles appear normal. Mucous retention cysts are seen in the maxillary sinuses bilaterally and in the right aspect of the sphenoid sinus. No air-fluid levels are identified. The mastoid air cells and middle ear cavities are normal.
Impression:
Small focus of nonspecific abnormal increased T2 signal in the medial aspect of the right temporal lobe. In the absence of symptoms associated with this region, a follow up study is recommended in 6-12 months to confirm stability, as a low grade glioma can have this appearance. Alternatively, this could be an atypical presentation of a demyelinating process as this lesion is in the periventricular region. No other white matter lesions are identified to support diagnosis.
If you don't trust in your doctor then it might be best for you to get a second opinion. Unfortunately there is not doctor on this message board that can read your results, nor can anyone diagnose you over the internet.
If your doctor is not concerned that's a good thing, but if it's worrying you, then get a second opinion. Bring your results and medical records for another doc to see.
Best of luck and health to you!
HE IS NOW IN GERMANY DOING RADIATION THERAPY TO EXTEND HIS LIFE.....THE "NON CANCER" GREW AND SENT METS THROUGHOUT HIS BODY!
DEFEND YOUSELF AND DONT ACT LIKE A DEER IN HEADLIGHTS. FIND THE BEST ONCOLOGIST IN TOWN AND SET UP AN APPOINTMENT......NOW
My follow up MRI has been moved up to January. My new neurologist did another MRI with contrast and my lesion did not enhance. On the new MRI they found a microadema (spelling?) on my pituitary area. The neurologist after examining me ordered the spinal tap due to MS symptoms. She seems to be very smart and I like the fact that she is aggressive in trying to figure everything out. The spinal tap was not fun, but if it helps to figure out my situation it was well worth it. I will keep everyone updated. Thank you for your replies.
I hope all is well with you at this point. Follow-up is wise and second opinions are always a good idea if you have concerns.
Generally,
When there is a mass (anywhere) that is not causing any symptoms, there is decreased need for concern. This is especially true when there are no abnormal lab tests, history of similar disease, or related diseases in the family. The reason a mass is monitored, however, is to make sure that it is not changing. When a mass does not change over time, it is considered stable and that is reassuring. The more time that goes by without changes in the mass or presence of symptoms, the more reassuring. Doctors may continue to check periodically for change, but more important are regular checkups and physical exams to assess for new symptoms.
Demyelinating refers to a process where the fatty cells that line nerve fibers are being destroyed. The most common disease involving demyelination in the brain is multiple sclerosis, an inflammatory disease. Symptoms of MS vary between individuals and between episodes. Lesions in MS usually come and go, so initial suspicion of that disease in particular would require later evaluation for change (multiple lesions will often appear in different parts of the brain and tend to go away after an episode). MS is usually progressive with each recurring episode a little worse than the one before, but some people with this disease can function very well.
In your update you mentioned a pituitary adenoma? The pituitary is a small gland toward the front of the brain that is responsible for tons of hormone regulation in the body. Sometimes a pituitary adenoma can secrete extra hormones of various types that could lead to a host of different symptoms. If the tumor becomes large enough, it can press on nerves that are involved in sight and lead to a loss of vision or it can press on surrounding cells that make hormones and cause the secretion of hormones to decrease. Smaller tends to be be better, and of course, no change over time and no development of symptoms is a good thing.
Anyone should contact a physician if any new neurological symptoms develop (but especially someone with a known lesion in the brain). Examples of neurological symptoms include difficulty moving limbs or facial muscles, difficulty walking, difficulty maintaining balance, change in ability to speak, visual loss, doubled or blurry vision, headaches, loss of feeling sensation anywhere on the body, changes in ability to urinate or pass stool, or decreased ability to focus, think, or remember things.
Some possible pituitary symptoms include changes in weight, excessive sweating, difficulty tolerating either heat or cold, changes in hair texture, loss of hair or increase in facial hair, fatigue, weakness, sleep dysfunction, sexual dysfunction, abnormal expression of milk from breast tissue (even men), increased or decreased bleeding in menstruation (women), or exaggerated growth of facial bones. Also, there is the possibility of partial vision loss or "narrowed vision." Blood sugar and blood pressure are increased in some cases.
Even if new symptoms go away with time, the affected individual must see a doctor or visit the ER because these symptoms are indication of many possible neurological diseases or injuries, and cessation of symptoms does not mean there is no problem.
God bless, and all the best to you on your journey,
Nej
http://gerson.org/case/case0.php?case=9
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