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Hello, I Would Like To Know The Results Of My

Posted on Wed, 8 Jan 2020

Question: Hello, I would like to know the results of my brain MRI. I dont know what this bright spot near the vastibular nerve is. Can it be Vastibular shcwannoma? Or other shcwwannoma near the petrous apex or lesions? The the second picture that is highlightet what can this white cluster shaped thing be? I can tell you a bit of the symptoms that I have got. For the past 3 months I have had tingling and needl sensation starting from right eyebrow then radiating towards the left side and the entire forehead and right eyelid and sometimes even towards the tip of the nose. the sensation never stop no matter what I do. I feel dizzy all the time like if Im on a boat. When I tilt my head and move It gets even worse and starts spinning. I have har time looking at an object and cannot focus. My left eye is getting blood red whenever I look at a screen. My doctor prescribed kontisone tablets that did not help. My left ear feels clogged and my hearing on that ear is reduced too. I also have tinnitus lately on the same ear. doctors at first tought it was due to B12 or Iron deficiency but both are at normal range. My blood preasure is normal too. Lately I have this numbness and tingling sensations om my feet and fingers too and whever I visit the toilet when I check the stool is Yellowish color and floats on the water and no solid shape to it as its braking a part. The full blood tests show absolutly normal for liver, pancreas and bile. Blood sugar levels are also normal. DICOM Files: https://icliniq.dicomgrid.com/api/v3/link/external?d=54df7bdf-44bc-4d9b-98bd-9ce01f0fca92&integration_key=q_0000

Answered by Dr. Prof. Kunal Saha (2 hours later)

Brief Answer:
Seems to be vestibular schwanoma

Detailed Answer:
Thanks for using the Ask a Doctor service.

I have gone carefully through your query and have checked MRI images. Indeed it seems to be a vestibular schwanoma near the petrous apex/internal auditory meatus. The symptoms correlate. There could be deficiency of vitamin B12 and taking methylcobalamine could help. The blood pressure level is independent of this.

You need to see a neurosurgeon (intracranial interventions are done by neurosurgeons).

Regards

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Prof. Kunal Saha (3 hours later)

Hello doctor thank you for the answer,

My doctor told me that its just a vessel. I Think he might be wrong because the spot is shown White on a T2w image and vessels dont show White on T2w MRI.
It also shows Bright White on Flair Image. This was just 3 images I could upload. but if Im able to upload a link with full MRI images can you check them all please. They are high detaild images DICOM format. plaese thanks for your suport.

Answered by Dr. Prof. Kunal Saha (2 hours later)

Brief Answer:
If it has a linear traceable course, it can be a vessel, not otherwise

Detailed Answer:
Thanks for writing back. I understand the dilemma but am not able to open the dicom format (none of the five segments seem to open). The bright spot needs to be traced. If it has a linear traceable course, it can be a vessel, but if not, it could be otherwise. It would be best to take the dicom format to a radiologist (not online) and to get his opinion on the matter.

Regards

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Prof. Kunal Saha (1 hour later)

Dear professor,

Can you please explain or give a brief example what a " linear traceable course" would look like. If you look at this image I just attached this is the same image but I have highlighted the right side. The same kind of structure can be seen over on this side too but not the same brightness whiteness to it. Does it mean that this side could be a shcwannima as well or is it something else. What structures should normally be in this area generally? Is it bone, air cell or some other tissue? These two other images are axial t2 propeller MRI

Answered by Dr. Prof. Kunal Saha (18 hours later)

Brief Answer:
Cholesterol granuloma more likely. Nothing needs to be done about it.

Detailed Answer:
Sorry for the inadvertent delay in responding. The way an MRI is done is serial cuts are taken and if we connect a finding on one MRI image with the next and the next and so on, we can get a traceable course to compile a mental 3D projection of what the object looks like and therefore concluding on what it could be. With respect to the looks of the given three images, it seems to be a cholesterol granuloma rather than a vessel. It is not bone and not air. The finding is on the left side and your complaints are on the right. So, they are possibly unrelated.

Regards

Above answer was peer-reviewed by : Dr. Nagamani Ng