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Old 08-13-2010, 03:48 PM   #1
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Understanding a radiologists MRI report

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Hi,
A couple months ago I had a surgery for a Chiari malformation. I just recently had an MRI, which detected leakage of the CSF around the surgery sight, but the MRI also mentions other things that I cannot make any sense of. The first MRI that was done before my surgery never mentioned any of this other stuff. I would like someone who knows how to read these reports to give me an idea of what this is saying to me in terms that I can understand especially the red shaded sentences, and does this finding present a new problem.

Thank you.

H


MR BRAIN:

This patient is status post suboccipital craniectomy for decompression of a Chiari malformation. The brain parenchyma demonstrates a single focus of aberrant bright signal intensity in the deep white matter of the left occipital lobe. The appearance of this structure is non-specific. It measures 3 millimeters in greatest dimension. It is bright on long TR imaging and of diminished signal intensity on short TR imaging. It may reflect an area of focal small vessel ischemic change. There are similar foci adjacent to the occipital horns of both lateral ventricles and the frontal horns of both lateral ventricles. These may well reflect focal ischemic change as well. No intracranial hemorrhage or mass lesion is seen. The ventricles are normal in size. There is extensive inflammatory change in the paranasal sinuses, particularly on the left. A pathologic fluid collection is identified in the midline of the left craniocervical junction incident to the prior surgery. There is no suggestion of Chiari malformation at this time.

IMPRESSION:

1. No etiology for headaches is identified on this study.
2. Status post-suboccipital craniectomy for Chiari malformation decompression. There is a pathologic fluid collection identified in the midline of the cranial cervical junction posteriorly at the operative site.
3. Foci of aberrant bright signal intensity felt to reflect the sequela of small vessel ischemic change in the periventricular region and right occipital lobe as described above.

Thank you.

 
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Old 08-16-2010, 06:37 AM   #2
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Re: Understanding a radiologists MRI report

have you spoken to your neurosurgeon about the other findings? some of this stuff, since it was NOT there prior to the surgical decomp was performed, just could be kind of the 'normal" for what you had done? like areas of inflammation and the ischema within the small vessels too? i would imagine just doing what they did, and having this done within the brain at all would have possibly 'damaged' some level of the smaller vessels possibly? ischemia is kind of a basic level of either no or very low level of bloodflow? any surgery just can cause small vessel damage. its just a bit more concerning of course when you see this show up in your own brain MRI. when i had to have a surgery done that went into my spinal cord to resect what was basically a glob of blood vessels, i too suffered surrounding damage. it kinda comes with the territory, ya know? but it does not appear from this report that anything was 'hit' or directly damaged or fully impaired in any huge way? at least that is my take on this? and the chiari is now gone too?

were they able to actually do a blood patch or 'do' anything to that area to actually stop that CSF leak in some way? now THAT would definitely cause some major headpain til its been mitigated and the fluid stops leaking? just looking at the heading up there? it appears this was done on you(the MRI) to see if there just was anything else besides that fluid leak to create your headpain? the best possible explanation of this would come from the surgeon who simply performed any surgery on a patient. all we can do is really kind of 'guess? i am not as familiar with the brain as i am with the spinal cord, but my mom has had an 'ischemic' stroke before? i have had a brain aneurysm and my son suffered a brain bleed, so those are "my' areas of info and hopefully no more 'info' will come my way since i kinda had enough there now?

but DO speak to your surgeon about this report and how you are simply doing now overall. i hope things will heal up nicely for you after this. good luck, FB
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