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Forum Name: Neurology Topics

Question: cavernoma located in the basal ganglia


 Maryam - Mon Dec 24, 2007 2:12 am

Dear Sir,‎

I am a 33 year old female working as a Computer Trainer and I am ‎seeking your help and advice. I have done MRI and MRA because I lost ‎the hearing in my left ear suddenly and without any pain while I was ‎training (15 March 06). I did not know that I lost the hearing till my sister ‎called me on my mobile, so I went to 3 E.N.T specialist who did a lot of ‎tests and they found that there is nothing wrong. After one week I ‎gradually regained the hearing in my left ear. 5 month later I started ‎having strange feeling while eating where I feel that I am fainting or may ‎be it is better to describe it as coma (I don't fall down I will still be sitting ‎on my chair) that remains for few seconds in which I don't feel of anything ‎around me. I also have numbness feelings in the bottom right side of my ‎head from back, some other times I feel as if there is some lump or ‎something hard in that same area bottom right side of my head from ‎back. ‎

On the left side of my head I have a severe burning feeling and some ‎times I feel as if someone is putting pressure on my head and I do suffer ‎from headache not the normal headache that I used to have before. Now ‎I am suffering from some weakness in my left hand fingers, even if I am ‎not holding anything still I feel that my fingers are tired. I also find small ‎amount of blood in my nose-left side- the blood color is mostly dark, I ‎never had blood in my nose before. Sometimes I suffer from short breath ‎and those who are sitting beside me will clearly hear me breathing deeply.‎

As a result of all the above I went to see a neurologist who recommended ‎MRI in which he found a small lesion in the basal ganglion (5 mm), the ‎test conclusion was: MR findings are in favor of vascular malformation ‎‎(?cavernoma,? angioma). I discussed my MRI result with an online ‎neurologist and this was his reply to me:‎
‎“Sudden Hearing Loss and Dizziness may indicate a process affecting the ‎vestiboulocochlear or 8th cranial nerve system which is responsible for ‎balance and hearing. I can tell you with certainty that a cavernous angioma ‎‎(cavernoma) located in the basal ganglia would NOT cause sudden hearing ‎loss in one ear as the only location in the central nervous system that can ‎cause this is a specific area of the brainstem (way below the basal ganglia) ‎where the 8th cranial nerve enters in the region of the upper medulla / lower ‎pons. Any areas "above" this place cannot cause hearing loss in one ear as ‎the information regarding hearing crosses from side to side and therefore any ‎problem would affect the hearing in both ears”‎

‎ After one month I did MRA. But after that the neurologist did not tell me ‎what the next step is if there is any, and if there is any relation between ‎all the above symptoms that I have and the lesion that was found in the ‎left side. And what is the difference between the cavernoma and the ‎angioma if there is any difference. I don’t know what I should do, what is ‎my next step. I stopped giving classes as the headache and the burning ‎feeling increases once I finish the 2 hours class- I take 2 and sometimes 3 ‎classes a day.‎

Please advise me what should I do and if you recommend any farther test ‎to be done.‎

Thank you very much for your time.‎

Maryam
 Dr. Chan Lowe - Fri Feb 01, 2008 7:37 pm

User avatar Hi Maryam,

I agree with the neurologist that one sided hearing loss is not likely to be from a basal ganglia cavernoma. A Cavernoma is another name for a cavernous angioma or cavernous hemangioma (all the same). These are collections of blood vessels that form a ball. In many people they are asymptomatic although they can bleed or cause pressure on surrounding structures in some cases.

I would recommend that you continue to follow up with your neurologist for further evaluation of these symptoms. Unfortunately, I can't really suggest anything that would be causing this. Follow up with the ENT doctor may also be helpful.

Best wishes.

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