I have posted on the spinal cord disorder board and it was suggested that I post here for some feedback. So here is the written report for my brain and part of my cervical spine report. I would like to know if anyone could tell me what the possible issue could be with the 2 small high T2 signal foci issues. This kind of caught me off guard as I had been having issues with my neck, shoulders, and arms. I would greatly appreciated and all comments. Thank you in advance!!~~
Brain- with and without contrast
Findings: There is mucosal thickening involving bilateral maxillary sinuses, ethmoid air cells, sphenoid sinuses. There is a 1 cm small mucous retention cyst within the right sphenoid sinus. Bilateral intraorbital contents are normal. There is lower lying of cerebellar tonsils.
Intracranially, the ventricular size and cisternal spaces are normal. There is no mass effect or midline shift. There is no hydrocephalus.
The FLAIR images demonstrate two small high T2 signal foci within the left anterior frontal lobe, one surrounding the frontal horn of the left lateral ventricle and another one within the left frontal lobe subcortical white matter. In addition, on sagittal view, there is high linear T2 signal along inferior margin of the corpus callosum. These findings are non specific.
There is no signal loss on susceptibility weighted image to suggest intracranial hemorrhage.
There is no increased diffusion to suggest acute infarct.
There is no abnormal enhancement on post contrast images within brain parenchyma. There is no meningeal enhancement.
1. Two small discrete hight T2 signal foci within the left frontal lobe white matter as described above. In addition, there is linear high T2 signal along the inferior margin of the corpus callosum. These findings are non specific and of uncertain etiology. Possible causes include a demyelinating process, hypertension, or other inflammatory etiologies. However, these findings are not diagnostic of any particular etiology. It is uncertain whether these findings are related to patient's current symptoms.
2.No abnormal enhancement within brain parenchyma. No acute infarct, mass effect or hydrocephalus.
3. Paranasal sinus disease as described above.
4. Low lying cerebellar tonsils. Please refer to cervical spine MRI on same day for further evaluation.
Cervical Spine- with and without contrast
The visualized portion of the brain demonstrates low lying cerebellar tonsils extending 4 mm below the foramen magnum, suggesting ectopia, but not meeting criteria for frank tonsillar herniation. (on a personal note, I thought I read that Chiari Malformation guidelines were 3-5 mm below? Could I possibly have that?)
Wow, has your neurologist had a look at all the pictures with you?? In the last six months have had a bunch of MRIs concerning having two brain surgeries to remove two small tumors.
The way they were positioned two surgeries were the best choice so I wouldn't be under so long.
Especially in the beginning it was very helpful to me to see the why and how of it all??
Also an eye problem after all that and again was able to use a machine my eye doc has that sort of removes layers visually to see changes in nerve activity. When he told me the situation, I swear he threw out three words with 20 letters each.
I don't know about most people but actually having something ewxplained with a visiual is a good thing??
Looks like you do some studying on your own, even though many people told me not too, I couldn't help it. Can see where it can be scary if you aren't able to ask for more information and clarification.
I have some good experience with what your asking about.
First of all I have a 6mm cerebellar tonsillar ectopia(I see you have a 4mm one)..like you I have no other characteristics of Chiari Malformation I.I had over 30 symptoms at the time I had that MRI.I noticed that your report mentioned the "demyelinating" as a possible cause.I had that also and the reason was because I had a low B12 level.You seriously need to have your B12 level checked...normal range is 200-1100 and if you're under about 450 you need to have an MMA test to see if you have higher than normal methylmalonic acid levels which means you havean "occult"(hidden B12 deficiency.So you would need to be treated with B12 injections.
I don't know what your sx are,but low B12 presents with numerous neurological symptoms.
Don't worry about the 4mm ectopia...one in four persons has a cerebellar ectopia my neurologists told me.
Post back and ask any questions you may have...I do know quite a bit about what you are concerned about.Also I've heard that those "signals" could be related to B12 deficiency too and degeneration of the spinal cord.
What did your dr. tell you concerning your test results?I would think you were given an explanation about everything?Drs. these days are so in a hurry and that can lead to wrong dx's for sure...hope my comments help you in some ways~
Well first let me say thank you for your responses. The neurologist who ordered the MRI's didn not seemed concerned about the spots on the brain or the low lying tonsils as the radiologist who looked at and commented on them said my MRI of my brain was 'unremarkable'. (I kinda took offense to that!~ ha ha!)
The cervical spine MRI showed a possible arteriovenous malformation or fistula and now I am waiting for a spinal angiogram. The worst part is this stinking hurry up and wait crap!!~ As I said, I posted the results of my MRI's on the spinal cord boards and it was suggested that I post my brain results here to perhaps see if any of it was related.
At this point, I don't care what it is, I just want to feel better and at least have 1 day without pain! I am so tired of feeling like a nut case. I have these tonsils that are not quite low enough to be a problem, and I also have mild narrowing, .9 cm, at C5-6, and also mild degenerative disc disease. Then this stupid, possible AVM at the bottom of the C spine/top of the T spine. I am so tired of hearing the word "mild" and then being overlooked and being told basically that my 'stuff' shouldn't be causing any pain. Im sure after the angiogram, they will say it is a 'mild' AVM and just send me home!!~ I'm just venting.....I just feel like I'm caught in some middle area....not too good and not too bad. Do you know what I mean?
It's been a week now and they still haven't even contacted me to even tell me when my angiogram is and all the while I am being so good at not allowing the fear and anxiety to kick my butt worrying about whether or not this 'thing' is going to rupture/bleed. I'm not scared, just mad....The neurologist orders this stinking MRI and it shows all of this crap and he doesn't even schedule an appt with me to go over it....just go do this other test. Then I call his office, because I think I'm doing the right thing, to ask him to refer me to a pain specialist and no one returns my call. I do truly know now what all of you mean by being your own advocate. I just can't believe a Dr would give a potentially life changing diagnosis and then just pawn me off to some other Dr with no follow up at all with ME....the patient! It just sucks and I am overwhelmed.....
i am glad you came up here tashia. i knew some people uphere could help you with the brain stuff/chiari much better than i could. so they STILL have not called you about that angio yet? i would just call them and keep calling them til they get this set up for you. this just IS being your own advocate hon. unfortunetly sometimes we simply have to be a bit more loud and demanding because people just do not always do their jobs for us as they are supposed to so we get lost in that shuffle?
you just DO NEED better definition of that vascular finding since we still do NOT yet even know what that is? this could be AVM or fistula, or even a cavernous hemagioma, but you never really know anything til that angio that defines what IS running thru it/feeding it at the vascular level just gets done. THEN you will have a much clearer idea of what it is and what possible(if any) real treatment options are needed? the fact that this is actually running on the very back side of the spinal cord and not the front makes it at least much more easily accessable for possible treatment options, so that is a good thing too in certain ways. believe me hon, you would be amazed at what they can do as far as treating these types of malformations even strictly thru just vessels at times too?
but the other really crucial thing you need is that neurosurgeon to go over all the findings with you and NOT a mere neurologist? a neurosurgeon needs to fully evaluate you and also the hardfilms and also help you with any possible treatment options too. with most vascular malformations you just will have what i mentioned before and who will also do your angio, a neurointerventional radiologist? between a good NS and that neuro rad, they will be the ones who will come up with or perform any actual procedures needed. and you CAN obtain a referral to a good PM clinic thru either that neuro or even your primary doc too?
i would just start calling people here and get this ball rolling so you can quit hanging in limbo here and actually find out what all this simply means for you. i do think you have waited long enough just to obtain an actual angio for gods sake. hang in there tasha, we will get you thru this, K? marcia
11-20-01,placement of hardware for failed fusion
9-22-03,removal of cavernous hemangioma that was inside spinal cord. Neuro damage to L hand L leg and R leg.