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Forum Name: Neurology Topics

Question: Pineal Gland MRI Question


 thammond - Mon Aug 13, 2007 7:43 pm

My daughter is 15 and while looking for the cause of her headaches that are frequent and debilitating, senorineural hearing loss and ENG report that said dizziness came from CNS they did an MRI no contrast and found venous angioma left pariteial lobe (nothing to worry about) and with CT large vestibular aqueduct. We were told to keep her out of cheerleading which did help slow the hearing loss however they said the angioma was not the cause for her headaches and dizziness with nausea, we moved out of state and found a new Neurologist who ordered another MRI with contraast this time. It shows a 5x6mm pineal lesion with peripheral enhancement and says we should do follow up MRI's to check stability. My question is what is peripheral enhancement and what is it's signifigance with a pineal lesion. Also is it possible that she doesn't really have large vestibular aqueduct and possibly the lesion is causing pressure in that area? I don't know if they are near each other or not but curious to know.
Thanks
 Dr. Chan Lowe - Fri Aug 31, 2007 3:53 pm

User avatar Hi Thammond,

Peripheral enhancement means that when the contrast was given, the outside edge of the mass lights up during the MRI pictures while the inside does not light up as much giving a ring look to it. This is common of a pineal cyst.

Pineal cysts are quite common and slightly more common in women than men. Typically they are incidental findings noted on MRI's when the study is done for some other reason. However, they can get big enough to cause symptoms of increased pressure in the brain. Your daughter's sounds like it is on the smaller side. It may or may not be large enough to cause symptoms.

I would recommend you talk with a neurosurgeon to get a specialist opinion about whether this could be causing problems or not.

The pineal gland is close to the aquaduct but I'm not sure that the size of her cyst is large enough to cause problems. I'm not knowledgeable enough about this to say for sure.

Another thing that should be considered for her headaches given that she has a dilated aquaduct is a condition called pseudotumor cerebri, which is an elevation of the pressure of the spinal fluid without an underlying obvious obstruction. It's called pseudotumor because it can have the effects of a tumor blocking spinal fluid flow but without the tumor.

Best wishes.

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