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Suggest Remedy For Cyst In The Centrum Semiovale Of Infant
Question: Good Evening,
My daughter was born 3 months premature and is now 38 weeks and doing well. On a routine ultrasound at 30 days old a 4x3mm cyst was found in the Centrum Semiovale and the doctors were concerned she could have a pvl. Routine ultrasounds after showed no further cysts or bright spots and they thought this is likely a benign cyst and we would do an mri before discharge to confirm what was going on. We just got the results back from the mri and no further cysts have developed. The radiologist did note bilateral hyperintensity t2 signals bilterally and linear. He thinks it's pvl. the neonatologist says it is not pvl and it is normal mylenation in a preemie as the areas do not connect with the ventricles and is separated by healthy tissue. he was pleased with the mri and thinks she will be okay and just have to wait and see what kind of effect the small cyst will have on her. the ventricles were of normal size and the brain appears normal otherwise. the mri seems to have confused us more now and are quite stressed. do you have any idea what if anything we can do next? is the mri the last test we can really have? would a cat scan show anything different. is this pvl or not? I have picture of her brain and attached a copy of the radiology report.
My daughter was born 3 months premature and is now 38 weeks and doing well. On a routine ultrasound at 30 days old a 4x3mm cyst was found in the Centrum Semiovale and the doctors were concerned she could have a pvl. Routine ultrasounds after showed no further cysts or bright spots and they thought this is likely a benign cyst and we would do an mri before discharge to confirm what was going on. We just got the results back from the mri and no further cysts have developed. The radiologist did note bilateral hyperintensity t2 signals bilterally and linear. He thinks it's pvl. the neonatologist says it is not pvl and it is normal mylenation in a preemie as the areas do not connect with the ventricles and is separated by healthy tissue. he was pleased with the mri and thinks she will be okay and just have to wait and see what kind of effect the small cyst will have on her. the ventricles were of normal size and the brain appears normal otherwise. the mri seems to have confused us more now and are quite stressed. do you have any idea what if anything we can do next? is the mri the last test we can really have? would a cat scan show anything different. is this pvl or not? I have picture of her brain and attached a copy of the radiology report.
Brief Answer:
Our youngest daughter was a 26 week preemie
Detailed Answer:
Good evening. I'm a neurologist from XXXXXXX Ohio, USA. When I was in residency training our youngest daughter (of 4 children) was born 26 weeks gestation. She spent 7 months in the hospital....over 2 months in NICU. I understand what you're going through. We lived in the hospital 24/7 and took shifts to be with her on average 22-24 hrs./day. She had a germinal matrix bleed which was Grade 1. Because I was a resident at the hospital she was being cared for in I was on the computer systems, at the nurse's station, pulling her chart off the rack day and night, constantly on top of the nurses, the residents, the attendings, they hated ME...they liked my wife...although she didn't allow things to go by the wayside either but I was just much less forgiving if something didn't get done on time.....
The reason I tell you all of that is so that you may know that I've been where you're at and if your neonatologist says that something is NOT something or that things are "Ok"....then, take that and have a party! We were constantly looking for someone just to say that something was going in a positive direction for the first 2 months....it did eventually but till that point...nobody would tell us really anything positive.....so as I said, if the neonatologist says things are good....then, trust me....they're not just whistling Dixie...they mean it. Neonatologists are typically cynical people to begin with which makes them even more cynical doctors. They will not commit to anything until God himself writes it on a piece of paper and hands it to them.....don't worry about the radiologist.
Most of the time radiologists overcall the reports just because that's the way they're trained....they MUST call every defect, or potential defect, they must identify and recognize every nuance of a film that is either NOT normal or potentially NOT normal.
I looked at the scans and that is not PVL by any means. If it were, I'm afraid your baby would be having MAJOR problems with movement, alertness, feeding, and really everything. Those are myelination tracts in a neonate.
You need not be stressed by the MRI because it is a normal scan for this baby. A CT scan is about 10-100x less sensitive than MRI to pick up defects so, "No" CT will not show anything MORE than an MRI...quite the contrary....it will show much less....I see no point in doing further testing. Those white matter tracts will be going through myelination for quite some time so don't look for them to immediately get resolves.
Once again and to re-emphasize the MRI findings which I've seen and read in the report...DO NOT demonstrate PVL....
I'd appreciate the favor of your providing a STAR RATING and some brief written feedback if your question has been satisfactorily answered. In addition, CLOSING THE QUERY on your end will also be most helpful.
Don't forget that my webpage to keep me abreast as to how you're doing is:
bit.ly/drdariushsaghafi
All the Best
This query has required a total of 20 minutes of physician specific time to read, research, and compile the return envoy to the patient.
Our youngest daughter was a 26 week preemie
Detailed Answer:
Good evening. I'm a neurologist from XXXXXXX Ohio, USA. When I was in residency training our youngest daughter (of 4 children) was born 26 weeks gestation. She spent 7 months in the hospital....over 2 months in NICU. I understand what you're going through. We lived in the hospital 24/7 and took shifts to be with her on average 22-24 hrs./day. She had a germinal matrix bleed which was Grade 1. Because I was a resident at the hospital she was being cared for in I was on the computer systems, at the nurse's station, pulling her chart off the rack day and night, constantly on top of the nurses, the residents, the attendings, they hated ME...they liked my wife...although she didn't allow things to go by the wayside either but I was just much less forgiving if something didn't get done on time.....
The reason I tell you all of that is so that you may know that I've been where you're at and if your neonatologist says that something is NOT something or that things are "Ok"....then, take that and have a party! We were constantly looking for someone just to say that something was going in a positive direction for the first 2 months....it did eventually but till that point...nobody would tell us really anything positive.....so as I said, if the neonatologist says things are good....then, trust me....they're not just whistling Dixie...they mean it. Neonatologists are typically cynical people to begin with which makes them even more cynical doctors. They will not commit to anything until God himself writes it on a piece of paper and hands it to them.....don't worry about the radiologist.
Most of the time radiologists overcall the reports just because that's the way they're trained....they MUST call every defect, or potential defect, they must identify and recognize every nuance of a film that is either NOT normal or potentially NOT normal.
I looked at the scans and that is not PVL by any means. If it were, I'm afraid your baby would be having MAJOR problems with movement, alertness, feeding, and really everything. Those are myelination tracts in a neonate.
You need not be stressed by the MRI because it is a normal scan for this baby. A CT scan is about 10-100x less sensitive than MRI to pick up defects so, "No" CT will not show anything MORE than an MRI...quite the contrary....it will show much less....I see no point in doing further testing. Those white matter tracts will be going through myelination for quite some time so don't look for them to immediately get resolves.
Once again and to re-emphasize the MRI findings which I've seen and read in the report...DO NOT demonstrate PVL....
I'd appreciate the favor of your providing a STAR RATING and some brief written feedback if your question has been satisfactorily answered. In addition, CLOSING THE QUERY on your end will also be most helpful.
Don't forget that my webpage to keep me abreast as to how you're doing is:
bit.ly/drdariushsaghafi
All the Best
This query has required a total of 20 minutes of physician specific time to read, research, and compile the return envoy to the patient.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
thank you for the response. I think sometimes you just need to hear something from someone outside the circle that we have now. we went from a pvl diagnosis because of a cyst, to just a cyst and no pvl, to pvl from radiology, to no pvl from the neo. just wanted to ask one more question. so the cyst that my daughter has in the Centrum semiovale, what does that area of the brain actually control. the doctor did say worst case she may have some stiffness in opposite side limb, which would be her left leg. he said it was so small it is likely to not cause any issues and generally they really do not get concerned unless it is 10mm or more.
Brief Answer:
Glad to be of service
Detailed Answer:
I'm just as sure as anybody can be while looking at the MRI that we are as close to ZERO % clinical significance of this cyst as possible. For one thing, I can't be sure that the cyst is REAL. I see the area under discussion, however, when looking at just 1 slice of the MRI it is difficult to make the call of something such as a cyst because I don't have contiguous slices in order to put the puzzle together.....know what I mean?
The semicentrum semiovale region is felt to be mainly a communications relay station so that "one side of the brain knows what the other is doing at all times" Yes, stiffness can occur if that cyst is a REAL LESION in that area....I simply cannot be making much of an interpretation of this structure since there is only 1 uploaded slice image.
I'd appreciate the favor of your providing a STAR RATING and some brief written feedback if your question has been satisfactorily answered. In addition, CLOSING THE QUERY on your end will also be most helpful.
Don't forget that my webpage to keep me abreast as to how you're doing is:
bit.ly/drdariushsaghafi
All the Best
This query has required a total of 34 minutes of physician specific time to read, research, and compile the return envoy to the patient.
Glad to be of service
Detailed Answer:
I'm just as sure as anybody can be while looking at the MRI that we are as close to ZERO % clinical significance of this cyst as possible. For one thing, I can't be sure that the cyst is REAL. I see the area under discussion, however, when looking at just 1 slice of the MRI it is difficult to make the call of something such as a cyst because I don't have contiguous slices in order to put the puzzle together.....know what I mean?
The semicentrum semiovale region is felt to be mainly a communications relay station so that "one side of the brain knows what the other is doing at all times" Yes, stiffness can occur if that cyst is a REAL LESION in that area....I simply cannot be making much of an interpretation of this structure since there is only 1 uploaded slice image.
I'd appreciate the favor of your providing a STAR RATING and some brief written feedback if your question has been satisfactorily answered. In addition, CLOSING THE QUERY on your end will also be most helpful.
Don't forget that my webpage to keep me abreast as to how you're doing is:
bit.ly/drdariushsaghafi
All the Best
This query has required a total of 34 minutes of physician specific time to read, research, and compile the return envoy to the patient.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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