Suggest Treatment For Tinnitus

Posted on Thu, 2 Feb 2017

Question: Hi Doctor:

I spoke with one of your doctors approximately 3 weeks ago who was very helpful with regards to my vertigo/imbalance. I did mention to him that I was going for an MRI of the brain. I am a bit concerned with the results which maybe you can explain for me. There is an anterior right frontal convexity, 11x5mm (is this size really small) ? Extra axial lesion compatible with a small meningeoma.There is no associated mass effect. Not sure what this means. Areas of encephalomalacia within the paramedian left frontal and parietal lobes. There is a homogeneous renal enhancement the surgical margin without nodular areas of enhancement to suggest tumor recurrence. Postoperative changes from craniotomy and meningioma resection at the vertex. No evidence for tumor recurrence in this location. Small right frontal meningioma without associated mass effect. What am I possibly looking at, hopefully just monitoring. My imbalance seems to be improving; I do get tinnitus at times, otherwise I am feeling better. The encephalomalacia concerns me as well. I had a meningioma removed 23 years ago. Now another meningieoma? Had an MRI of the brain about 6 years ago which was fine.
Thank you again for clarifying my concerns. Hope to hear from you soon.

Answered by Dr. Ishu Bishnoi (5 hours later)

Brief Answer:
MRI Interpretation and management

Detailed Answer:
Hi xxxxxxxxxxxx, thanks for asking from HCM.

I can understand your concern. As per your MRI report

- Your previous meningioma resection site is ok. There is no recurrence of previously resected meningioma. It is good.

- The encephalomalacia means brain scarring. You must not worry about it. The scarring can occur due to meningioma compression or surgery. It is dead area of brain. It will not cause anything except sometimes seizures.

- The meningioma at right anterior frontal is very small (11mm maximum size). Usually size smaller than 30 mm is insignificant. Also it is not causing any kind of mass effect. It means there is no pressure effect. If there is no pressure, that means brain is not getting damaged. It is good for you.
The meningioma is a very slow growing tumor, so to become more than 3 cm, it might take 3-5 years.

I think your report is good except new meningioma. But it is of small size, so you must not worry about it.

For symptomatic relief, you can continue with medication.

If you need any more help, do let me know.
Thanks. Take care

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

Follow up: Dr. Ishu Bishnoi (4 hours later)

Hi Doctor:

Thank you for your excellent reply. Healthmagic is so highly helpful in clarifying medical issues that I am so thankful and appreciated that it has been established for everyone. I just have one more question. Would the treatment be to just follow up with MRI's yearly and would there be a chance for the meningioma to possibly stop growing?

Answered by Dr. Ishu Bishnoi (7 hours later)

Brief Answer:
Treatment protocol and meningioma growth

Detailed Answer:
Hi xxxxxxxxxxxx, welcome back.

Thanks a lot for the appreciation. You are right regarding follow up. You will be advised to get MRI brain done after every year. It will be continued for first 3-5 years, then 3 yearly if no growth.

There is always a possibility of no growth at all. However it is less common. Usually growth rate of meningioma is 5-10mm in a year.

I think it will answer your queries. If you need any help, do let me know.
Thanks. Take care.

Above answer was peer-reviewed by : Dr. Arnab Banerjee