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    Old 04-16-2008, 09:44 AM   #1
    kmesoo1
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    Red face Evidence of abnormal enhancement?

    My MRI of my brain says that I have evidence of abnormal enhancement and I have been trying to figure out what that means and I see postings say something about a break in the blood brain barrier..what exactly does this mean? This sounds scary because in the other postings I have read it says well at least "no abnormal enhancement is seen and that's a good thing".

     
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    Old 04-17-2008, 08:23 AM   #2
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    Re: Evidence of abnormal enhancement?

    has anyone told you to come back for more definitive type of testing just to answer that question for you? abnormal enhancement can actually mean many many different things so it does need better definition. some things are no biggie but others could be more involved,you know what i mean? just the finding by itself really doesn't tell you much as you already know. i would very strongly ask your doc to either send you for more deeper better defined testing,or send you to a neuro for an eval and HE or SHE can send you for better testing. you just really need to know what the 'enhancement' is all about. like i said,could be nothing or a something,but you wont know til better testing gets done. there are a number of different scans that could better define this area for the docs. was this particular scan actually done WITH a contrasting agent or just plain MRI?

    just how exactly is this finding stated per your MRI report? look at the summary at the very end and if you could,please just state what is says about this particular finding. some clues can be found sometimes just in the way the radiologist actually writes the sentence or paragraph. what area of the brain is this in or is it within an artery or what? the more info you can give me the more help i can try to be for ya. marcia
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    Old 04-17-2008, 09:22 AM   #3
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    Re: Evidence of abnormal enhancement?

    feelbad...yes here is my MRI results with contrast..I am 41

    There are minimal nonspecific scattered hyperintense foci within the white matter of the bilateral corona radiata. Findings are nonspecific and could represent small areas of gliosis. Other considerations include hyperintensities which can be associated with chronic migraine headaches. A demyelinating process is less likely but not excluded. Evidence of abnormal enhancement. Cerebellar tonsillar ectopia is demonstrated with minimal cerebral spinal fluid posterior to the tonsils. No evidence of altered tonsillar configuration. Flow-void is present involving the internal carotid, vertebral, and basilar arteries.


    Impression: Minimal scattered nonspecific hyperintense foci on Flair images involving the white matter with above discussed differential diagnosis.

    cerebellar tonsillar ectopia

    My other postings list my symptoms which have gotten progressively worse since Nov. 2007 and I have never had a migraine that I know of. And no my regular doctor doesn't want to do anything else until I see the Neurologist but I have been suffering for months and I have been to his office almost once a week and to emergency 3 times in less than a month and they keep giving me antibiotics which help until I run out then I get sick again.

    Last edited by kmesoo1; 04-17-2008 at 09:29 AM.

     
    Old 04-20-2008, 07:58 AM   #4
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    Re: Evidence of abnormal enhancement?

    km, can you just list your sx here? I did see you've posted on the Lyme board... I'm not 100% sure but I believe when something is enhanced it always means that whatever is going on is "active".

     
    Old 04-20-2008, 11:11 AM   #5
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    Re: Evidence of abnormal enhancement?

    My symptoms are as follows:

    stiff neck and shoulders worse in the morning, sometimes my neck feels so weak I can't hold up my head, swollen lymph nodes neck and right arm pit..sore infected throat with pus and difficulty swallowing (diagnosed with strep/tonsillitis/pharyningitis within the same month) Sore red dry right eye only, blurred vision right eye only, light sensitive right eye only, pupil dilating for days or weeks right eye only, ringing in right ear only, extreme pressure headache right side only, seeing flashing lights when sleeping, and seeing flashing lights after going from a bright light to a dark room..looks like an old projector movie the way I see the light flicker really fast, dizzy, vertigo, shortness of breath, center of chest and back pain , right side shoulder and arm and elbow pain numbness and weakness and tingling in hand and fingers..muscle twitching and cramping in my face, neck, head, right arm just started getting muscle spasms last week in right thigh above knee. I can't think or concentrate or remember from one minute to the next. A light vibration or tremor through my arms, legs, chest, ankles, wrist. I have difficulty driving because I get dizzy, and same thing when watching TV like the pictures are moving too fast for my eyes, I have been told I am slurring my words which I don't even realize. I keep feeling this pulsing in and around my right eye and I can see it in bright light. I have an appointment with a neurologist on April 30th and I have been waiting since March 20th. I have been to my regular doctor numerous times since the 20th for my stiff neck, difficulty swallowing and sore throats and he still hasn't told me anything about my MRI results..he gives me antibiotics..so far I have been on zpack no help, amoxicillan, no help, now because I went to emergency on Friday because I had severe head and neck pain and stiffness and extreme difficulty in swallowing , chest and back pain and really bad chills..I showed the attending phyiscian my MRI results which I had done there at that hospital..and he said how long has this been going on and I said months he said what are you taking for pain I said extra strength tylenol so he gave me Darvocet 100, 2 to 4 times a day and Augmentin 875mg twice a day for tonsillitis/pharngitis..well that was Friday and today is Tues. and my throat is a little better but still hurts and so does my back and chest and I can't take the Darvocet because it made me feel like I had an elephant on my chest. I have been progressively getting worse since November 2007.

    Last edited by kmesoo1; 04-20-2008 at 11:13 AM.

     
    Old 04-20-2008, 12:28 PM   #6
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    Re: Evidence of abnormal enhancement?

    Glad to hear your neuro appt. is not so far away now. I know it is frustrating waiting. I would really suggest you ask for a referral to a neuro-opthalmologist as well. Sometimes neurologicial problems affecting the eye can be a big clue and they are the best type of doctors to investigate since they are trained in both neurology AND ophthalmology. I actually started my whole diagnostic journey with some eye sx and my regular ophthalmologist sent me to a neuro-op. Also, best to be on the safe side anyway -- you don't want to mess around with your vision. At the very LEAST, go to your regular ophthalmologist, who will probably give you a visual field test since your vision is blurry. One question about your eye -- if you pick up something bright red and look out of it one eye at a time, is there a difference in the brightness of the color that you see?

    Last edited by Bearygood; 04-20-2008 at 12:28 PM.

     
    Old 04-20-2008, 02:05 PM   #7
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    Re: Evidence of abnormal enhancement?

    My regular doctor told me to wait until I see the neurologist to see if he wanted me to see a neuro-opthalmologist..when I went to the regular optician for my right pupil being dilated for 2 weeks he said I had scleritis and gave me tobradex..so after a week and my pupil was still dilated I went to an opthalmologist who was freaking out about my pupil..those were her words.."your pupil is freaking me out" and could find nothing wrong with either eye and she said you need to see a neuro-opthalmologist..it's your brain not your eye. So I told my regular doctor who referred me to the neurologist. I hate waiting so long and worrying I might get irreversible damage in my right eye. I don't see any difference with bright red with either eye. I have extreme difficulty going from bright lights to dim..my right eye doesn't respond fast enough..at night it's even worse when my eye is tired. I can't stand any type of strobe, blinking, flashing lights they make me nauseaous. Thanks for your help.

     
    Old 04-20-2008, 04:26 PM   #8
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    Re: Evidence of abnormal enhancement?

    kmesoo1, I wish your doctor had taken a cue from the ophthalmologist. I think their recommendation to see a neuro-op was right -- a regular neurologist will NOT take the place of one. My suggestion would be to make an appointment NOW -- maybe you can even get in before the 30th and if not, at least you won't have to wait to first try to MAKE the appointment after your neuro appt. Could be another long wait...

    Did your eye doctor do any tests or just examine you physically? They should have administered a visual field and color test as a matter of course. Sometimes you don't even know what you're not seeing. I didn't even realize that my perhipheral vision was affected until my regular ophthalmologist tested me and also didn't realize there was a difference in color until she picked up a bright orange bottle cap and had me look at it one eye at a time. I thought I'd be leaving the eye doctor with a prescription for eye drops and instead, I left with a referral to a neuro-op. Who, by the way, did an MRI of the orbits. Sure sounds like it might be a good idea for you to have one of those too.

    By the way, one of the reasons I'm asking you about this stuff is because some of your eye symptoms sound like Optic Neuritis. There are a few things that can cause it and one of them is Lyme. (In my case it was MS.) It very well might not be ON but regardless, I really recommend you getting in to see that neuro-op. Don't mess with your vision.

    Sorry if I sound harsh but I'm just trying to help and unfortunately, I've seen too many people whose doctors have them running around in circles -- or at least taking a much longer way round than is necessary.

    Last edited by Bearygood; 04-20-2008 at 04:29 PM.

     
    Old 04-21-2008, 08:03 AM   #9
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    Re: Evidence of abnormal enhancement?

    wow,sounds like you have gotten much much better advice than i could possibly have given you. i too was going to suggest the neuo op tho, this is the type of doc i really need to see for my eye wierdness,just haven't gotten the referrral yet. but these docs are very good at Dxing problems stemming from brain injury and spinal cord injury. i have a spinal cord injury that i also believe is affecting my eyes due to some cranial and sympathetic nerve damage.

    one possibility for your constricted pupil could be traced back to some level of sympathetic nerve damage. i have that too but it is called a horners syndrome. this just popped in about three weeks post op after my spinal cord surgery was done. it occurs when something is damageing or affecting the sympathetic nervous system along its path to the eye. this is what 'my' pupil,only one,is from. it will not react to light in any way shape or form,just stays constricted so it is much harder to for me to actually see at night,which i just happened to notice. i also have been getting wierd 'pulsations" in my peripheral vision? very odd but they do coordinate with my heartbeat. just insane really. so i too have to get these eye things figured out. my brain was clear as of my last angio and MRI. i do have a brain anuerysm that was coiled in 05 that should not be doing any of this stuff. and there was nothing else wrong that showed up on my last MRI either.

    i really am interested in just what you actually find out tho. have they ever done an actual MRI on your c spine down to the c8 nerve junction? this is the exact level of qwhere my damage is in my cord. this area(between the c7 vertebrae and the T 1) is very highly innervated more than the other levels simply becasue alot of cranial and the sympathetic pop out from the head there and some nerves go back up into the head right at that point. so it could be a possible problem area that could partially explain some level of your symptoms too. just a suggestion. this is just where alot of my facial/head problems actually stem from incuding that horners syndrome.

    hopefully this neuro you are going to be seeing will be one of the more knowledgable ones and will be able to actually give you something to go on here. but the neuro op really would be the best choice here given your symptoms. i do wish you lots of luck with this. please keep us posted,Marcia
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    Old 04-21-2008, 08:48 AM   #10
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    Re: Evidence of abnormal enhancement?

    Bearygood..I agree I should go to the neuro-op but I need a referral from my doctor who thinks I should wait until I see the neurologist. I made an appointment today to see my regular doctor because I am having extreme difficulty swallowing and I can taste blood..and my chest and back hurts..I think it's my esophagus. I still have a sore throat and bumps on my epi gilotta thing and white spots on my left over tonsills after taking augmentin 875mg twice a day for 7 days. I will tell my doctor about my eye getting worse and my concerns with my vision..maybe he will listen. I really think he thinks I'm a hypochondriac because I have been going to him almost weekly and telling him all my symptoms..but he isn't doing anything. I don't think I had the field of vision and color test. I had the dilating drops and she looked through the machine and asked me to read the line which at the time my vision acuity seemed ok. I had the test where I had to look into a machine and press a button when I seen a flashing light. I passed that too. Thanks again..I appreciate all the suggestions. Kim

     
    Old 04-21-2008, 09:00 AM   #11
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    Re: Evidence of abnormal enhancement?

    Feelbad:

    I am sorry to hear about your brain and spinal cord injury.. and hope things work out for you. I haven't had an MRI of my spine yet only my head..I'm hoping the neurologist will think I need one. I wish I would have convinced my regular doctor to refer me to the neuro-op sooner. I have been sick since I was bitten by a tick in Sept. 2007 or Oct. 2007not sure exactly when. My symptoms keep getting progressively worse. Thanks for your help. Kim

     
    Old 04-21-2008, 09:51 AM   #12
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    Re: Evidence of abnormal enhancement?

    Ah, kmesoo, I'm so sorry. I've seen so many people who have this problem of doctors needing to be convinced it's not psychological. Glad you're going in to see your doc early. I DO hope he gives you the referral to a neuro-op. BTW, the flashing light test IS the visual field test -- good to know they did that because if they hadn't, I'd be wondering about that doc. That was certainly the right thing to do, as well as the suggestion to see a neuro-op.

    I hope that ticker answers you when you post on the Lyme board -- she seems to be very knowledgable.

    Last edited by Bearygood; 04-21-2008 at 09:51 AM.

     
    Old 04-21-2008, 05:16 PM   #13
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    Re: Evidence of abnormal enhancement?

    Bearygood..what a day! I just now got home..I've been gone since noon..My appointment with my doctor wasn't until 4:00. I was in such agony I decided to go to the clinic instead..because I thought what is my doctor going to do? I could barely swallow and was up all night feeling like I'm suffocating. I keep getting sharp pains in my back and chest and stiff neck. I just got off of 875mg of Augmentin Friday for strep/tonsillits/pharngitis..I don't think they really know what I have. I got in the clinic and told my story to the nurse beginning with the tick bite and no my doctor hasn't done bloodwork. She was very nice and attentive. I gave her my MRI report and emergency room report and told her I was just on Augmentin for 7 days for strep/tonsillits/pharngitis..I say all three because my doctor said I had strep and the other emergency room doc said I had tonsillits/pharngitis. So the doctor comes in and says whose your doctor and I told him and he said ah he's a nice guy and I didn't answer mostly because it hurts when I talk. Then he said when is your next appointment with my regular doc and I said well I had one today that I was going to cancel because I came here because I couldn't wait until 4. He said you need to go to that appointment and I'm getting upset and crying because I didn't want to have to drive all the way there. I feel so bad I just want to go home and go to bed without feeling like I'm suffocating. So he ordered a mono test, strep test, soft tissue x-ray of my throat..well my strep was positive again! The other 2 tests were negative. So now I'm thinking as I'm sure he was too what is wrong with my immune system? I keep getting sick over and over and this doctor asked me if I felt better when taking the antibiotics and I said yes.
    So the nice nurse comes in with a big suprise for me a shot of bicillin la right in the tush..like I wasn't in enough pain already. WOW did that hurt! Like a tetnus shot! So after that the nurse told me to wait for 10 minutes to make sure I didn't have any bad reactions..none were suspected and I didn't have any and she didn't want me to sit out in the waiting room and catch something else. She told me that this doctor talked to my doctor about getting me tested for lyme disease and my doctor would have the paperwork for me. Then walking was a challenge..it felt like I was kicked in the hip. So I went to my appointment and my doctor still wouldn't listen to me about the neuro-op..he insist I wait to see the neurologist first..and I said if I make it that long. I am so sick and tired and weak I feel like I'm slipping away. So my doc says you got strep again and shakes his head and I said how can I have tonsillits whe I don't have tonsills..and he said what's left of them can still get infected. So he assures me this shot will cure me..I'm not so sure! I have taken so many antibiotics and none of them doxycycline which is for lymes. If this doesn't work I don't know what else to do. I got 3 calls for job interviews which I need badly a job to cover all my medical expenses that are going to be astronomical because my insurance sucks. And I am to sick to work and I said to my doctor how can I work like this. He just stared at me. So I finally got my lyme test.
    And if I can make it long enough to get to the neurologist I will insist on seeing a neuro-op. Thanks again..take care..Kim

     
    Old 04-21-2008, 05:47 PM   #14
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    Re: Evidence of abnormal enhancement?

    Wow, Kim. I'm so sorry but the good news is that it seems like your doctor might have been put on a little alert. I think it's interesting that the ER doc's response to your doctor was "He's a nice guy", not "He's a great doctor". Not now (you certainly have enough to deal with!) but looking toward the future when things are calmer and you're feeling better you might want to think about getting a different PCP. If you're feeling distraught in the interim, this nice ER doctor might be willing to speak to you over the phone. Glad you're gettting the Lyme test -- FINALLY! Your story is unreal -- but unfortunately, nothing I haven't seen before.

    Do you know which lab your test was sent to? I do know that not all labs are as good as others for Lyme testing. It's quite an intricate thing -- not only infections but co-infections, etc. I urge you to go on the Lyme board again and post about your situation.

    Kim, I'm going to keep an eye on your thread here. Good luck and GOOD JOB today of being an advocate for yourself!!!! Not an easy thing to do, especially when you're not feeling well.

    Last edited by Bearygood; 04-21-2008 at 05:49 PM.

     
    Old 04-22-2008, 09:40 AM   #15
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    Re: Evidence of abnormal enhancement?

    Bearygood..Yes I totally agree with you about my pcp..he is a nice doctor but he is a DO and he likes to to a lot of referals. The ER doctor is supposed to do a follow up so hopefully he will help me out. I have been going to my pcp for 11 years that's why I haven't changed yet..figuring he knows me best. I guess I was wrong. I feel absolutely terrific today! I was up at 8:30 instead of noon and my throat and eye and chest feels much better. My neck is still sore in the back and a little stiff this morning but I can deal with that. My Lyme test was sent to Utah and I will post on the Lyme board to see if that is a good lab or not. I will keep you posted..Thanks again for your help..Take care..Kim

     
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