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Meningioma Removed 2015. MRI On 1/4/21 Shows Issues. Follow Up
Question: Meningioma removed 2015. MRI on 1/4/21 shows issues. Follow up visit with surgeon next week.
1. Want to know what questions to ask him.
2. Also does this look like dementia? I have multiple cognitive symptoms.
MRI REPORT HERE, I ATTACHED A FEW SLIDES AS WELL.
Narrative
EXAMINATION: MRI BRAIN WITHOUT AND WITH CONTRAST
HISTORY: Intraventricular meningioma post resection.
TECHNIQUE: 3T MRI of the brain with and without contrast.
CONTRAST: 10 ml Multihance
COMPARISON: 4/17/2017
FINDINGS:
Right parietal craniotomy is noted. There is encephalomalacia and
gliosis in the right parietal lobe. There is one cephalic dilation of
the atria of the right lateral ventricle. There is no evidence for
residual or recurrent tumor. There are T2 hyperintensities in the
white matter of both cerebral hemispheres. There is no midline shift
or herniation. Cerebellar tonsils are normal position. Orbital
structures are normal. Paranasal sinuses, mastoid air cells, and the
middle ear cavities are well aerated. There are normal flow voids in
the carotid siphons and basilar system. There is no evidence of a
dural sinus thrombosis.
1. Want to know what questions to ask him.
2. Also does this look like dementia? I have multiple cognitive symptoms.
MRI REPORT HERE, I ATTACHED A FEW SLIDES AS WELL.
Narrative
EXAMINATION: MRI BRAIN WITHOUT AND WITH CONTRAST
HISTORY: Intraventricular meningioma post resection.
TECHNIQUE: 3T MRI of the brain with and without contrast.
CONTRAST: 10 ml Multihance
COMPARISON: 4/17/2017
FINDINGS:
Right parietal craniotomy is noted. There is encephalomalacia and
gliosis in the right parietal lobe. There is one cephalic dilation of
the atria of the right lateral ventricle. There is no evidence for
residual or recurrent tumor. There are T2 hyperintensities in the
white matter of both cerebral hemispheres. There is no midline shift
or herniation. Cerebellar tonsils are normal position. Orbital
structures are normal. Paranasal sinuses, mastoid air cells, and the
middle ear cavities are well aerated. There are normal flow voids in
the carotid siphons and basilar system. There is no evidence of a
dural sinus thrombosis.
Brief Answer:
I would explain as follows.
Detailed Answer:
Hello and welcome to the " Ask a Doctor" service.
I have read your query, I saw the MRI image that you uploaded too.
There are two issues regarding the MRI:
1- the encephalomalacia is an area of brain-damaged usually after surgery or severe trauma, this is a normal finding after the removal of a brain tumor.
2- White matter hyperintensities that mainly are linked to unstable blood pressure, small vessel disease, autoimmune disorders, etc.
You can ask your Doctor for the risks associated with encephalomalacia, for example, seizures.
You can ask your Doctor for the possible causes of the white matter hyperintensities and further tests necessary to reveal the cause, possible treatment ways too.
You should discuss also the timeframes of the follow-up for these issues.
Hope you found the answer helpful.
Let me know if I can assist you further.
I would explain as follows.
Detailed Answer:
Hello and welcome to the " Ask a Doctor" service.
I have read your query, I saw the MRI image that you uploaded too.
There are two issues regarding the MRI:
1- the encephalomalacia is an area of brain-damaged usually after surgery or severe trauma, this is a normal finding after the removal of a brain tumor.
2- White matter hyperintensities that mainly are linked to unstable blood pressure, small vessel disease, autoimmune disorders, etc.
You can ask your Doctor for the risks associated with encephalomalacia, for example, seizures.
You can ask your Doctor for the possible causes of the white matter hyperintensities and further tests necessary to reveal the cause, possible treatment ways too.
You should discuss also the timeframes of the follow-up for these issues.
Hope you found the answer helpful.
Let me know if I can assist you further.
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Thank you for the advice on question to ask my surgeon.
Follow Up Questions:
1. If you were diagnosing this MRI what would be your prognosis on dementia in the future? I seem to have a rapid decline in cognitive skills such as processing information, getting lost in familiar places, forgetting dates, appointments, and even managing my finances as I have paid things twice or forget to pay all together or swear I had already paid.
2. Isth encephepelomacia a progressive disease? Will it continue to grow?
3. There are areas that are not connected to tumor site. Are those caused by something else?
I appreciate straight forward answers and with as much detail as possible.
Thank you in advance for your help. XXXXXXX
Follow Up Questions:
1. If you were diagnosing this MRI what would be your prognosis on dementia in the future? I seem to have a rapid decline in cognitive skills such as processing information, getting lost in familiar places, forgetting dates, appointments, and even managing my finances as I have paid things twice or forget to pay all together or swear I had already paid.
2. Isth encephepelomacia a progressive disease? Will it continue to grow?
3. There are areas that are not connected to tumor site. Are those caused by something else?
I appreciate straight forward answers and with as much detail as possible.
Thank you in advance for your help. XXXXXXX
Brief Answer:
Answered below.
Detailed Answer:
Welcome back.
Encephalomalacia is not a condition itself, is a consequence of brain tissue damage such as after surgery.
It is not progressive neither.
Cognitive issues in your case seem to be linked with the hyperintensities found in the MRI that point towards chronic ischemic changes of the brain.
Vascular dementia should be considered in your case, finding the underlying cause ( unstable blood pressure, small vessel disease, etc. ) and treating it should stop the progression of the cognitive symptoms.
Hope this helps.
Feel free to ask if you have further questions.
Answered below.
Detailed Answer:
Welcome back.
Encephalomalacia is not a condition itself, is a consequence of brain tissue damage such as after surgery.
It is not progressive neither.
Cognitive issues in your case seem to be linked with the hyperintensities found in the MRI that point towards chronic ischemic changes of the brain.
Vascular dementia should be considered in your case, finding the underlying cause ( unstable blood pressure, small vessel disease, etc. ) and treating it should stop the progression of the cognitive symptoms.
Hope this helps.
Feel free to ask if you have further questions.
Above answer was peer-reviewed by :
Dr. Yogesh D
Answered by
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