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Forum Name: Neurology Topics

Question: What to expect from Pineal Cyst and other findings on MRI?


 ampriscrafts - Tue Apr 21, 2009 10:11 am

I am going in to see a neurosurgeon and was wondering what to expect, what they may say.
I am 31 years old. I have Thrombocytosis of an unknown origin.
I have been having headaches, dizzy spells, numbness off and on of the left arm, hand and foot, tired all the time and no anemia, trouble sleeping, and memory loss.

I was sent for an MRI and the report says...
The ventricles and sulci are normal. There is no evidence of an infarct. There is no definite abnormal signal noted through the majority of the brain. However, in the left temporal lobe adjacent to the cavernous sinus there is an area of T2 hyperintense signal. This is seen on the axial image #7. I am unclear what this represents. There is similarly some bright signal noted at the right petrous apex which is consistent with some fluid in the petrous air cells.
Incidentally noted is a pineal cyst. It measures 8 mm. It does not cause any compression of the underlying brain structures.
Impression: 1. Subtle area of hyperintense signal noted along the medial aspect of the left temporal lobe. The etiology or significance of this is unclear. 2. There is mild left petrous apex opacification.

I have no history of high blood pressure but at my last few appointments and my last home check my bottom number has been in the 90s, but have always had normal blood pressure until recently. I have had 2 past surgeries for ovarian cysts but that's all for my past medical history.

Thanks for your opinion.
 John Kenyon, CNA - Mon May 18, 2009 8:52 pm

User avatar Hello --

The findings are fairly nonspecific, but since you have been having some symptoms the neurosurgeon will probably want to explore ways of further determining what the findings represent. Some of them, such as the bright areas, may be fluid, and the possible reasons for that are myriad. Since the radiologist wasn't able to decipher them they may be of no consequence or there may be some fluid accumulation due to some process or injury which the neurosurgeon might be better equipped to identify. The pineal cyst is probably not a major concern as they rarely are, and yours is very small. It could be related to the other findings but collectively they don't tell much. Again, the neurosurgeon may have some ideas as to how to connect these to your symptoms (especially the bright area around the left temporal lobe, which may be related to the numbness in the left extremities, which is the only real neurological symptom you have that isn't readily explainable by other means.

Hopefully the neurosurgeon will be able to shed light on what's going on and what the inconclusive findings on the MRI represent. This is difficult to break down at a distance and really does require the expertise of a specialist. Please follow up with us once you've had the consult and we can perhaps help enlarge upon what you learn then.

Good luck to you. Please follow up with us here as needed and update us after your consult.

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