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I need help interpreting my brain MRI report.
I have had extreme fatigue and sleepiness (I need to sleep 15-20 hours per day) for four years. I have been diagnosed with depression for four years but that has been unsuccessfully treated. I have been on 19 psychiatric medications over that time period. None have helped. Recently I have had left sided numbness and weakness, blurred vision, memory loss, and even musical (auditory) hallucinations.
Doctors can't figure out what's wrong with me. I had my MRI done. What type of cyst are they taking about and is it possible that it is related to my symptoms?
"Within the posterior right parietal lobe, there is a 3.5mm well-circumscribed fluid filled cyst. No associated hemosiderin deposition or restricted diffusion is identified at the level of this lesion. Just anterior and lateral to this lesion, there are some prominent linear Virchow-Robin spaces. The finding most likely represents a prominent Virchow-Robin space, although a post-infectious cyst cannot be completely excluded. BOLD susceptibility weighted images fail to reveal any abnormal calcifications within the brain parenchuma to suggestive neurocystsicercosis.
Sagittal and transaxial T1 FLAIR images fail to reveal any mass effect, midline shift, sulcal effacement, hydrocephalus or extraaxial hemorrhage.
Transaxial T2 FLAIR images reveal a few small foci of increased signal intensity within the supraventricular white matter, particularly within the right parietal lobe. These very small foci are nonspecific and could reflect migraine headaches or previous viral infection. Diffusion weighted images fail to reveal any ongoing regional or segmental ischemia. There is no MRI evidence for demyelinating disease. No lesions are identified at the level of either thalamus.
No suprasellar abnormalities are noted at the level of the foramen magnum.
As an incidental note, there are prominent Virchow-Robin spaces at the level of the basal ganglia and anterior commissure.
The sinuses and mastoid air cells are grossly clear. No air fluid level is identified at any sinus."
Doctors can't figure out what's wrong with me. I had my MRI done. What type of cyst are they taking about and is it possible that it is related to my symptoms?
"Within the posterior right parietal lobe, there is a 3.5mm well-circumscribed fluid filled cyst. No associated hemosiderin deposition or restricted diffusion is identified at the level of this lesion. Just anterior and lateral to this lesion, there are some prominent linear Virchow-Robin spaces. The finding most likely represents a prominent Virchow-Robin space, although a post-infectious cyst cannot be completely excluded. BOLD susceptibility weighted images fail to reveal any abnormal calcifications within the brain parenchuma to suggestive neurocystsicercosis.
Sagittal and transaxial T1 FLAIR images fail to reveal any mass effect, midline shift, sulcal effacement, hydrocephalus or extraaxial hemorrhage.
Transaxial T2 FLAIR images reveal a few small foci of increased signal intensity within the supraventricular white matter, particularly within the right parietal lobe. These very small foci are nonspecific and could reflect migraine headaches or previous viral infection. Diffusion weighted images fail to reveal any ongoing regional or segmental ischemia. There is no MRI evidence for demyelinating disease. No lesions are identified at the level of either thalamus.
No suprasellar abnormalities are noted at the level of the foramen magnum.
As an incidental note, there are prominent Virchow-Robin spaces at the level of the basal ganglia and anterior commissure.
The sinuses and mastoid air cells are grossly clear. No air fluid level is identified at any sinus."
I did look up the Virchow-Robin spaces as well. I found some sources that say they are normal, but they usually happen in older adults, but I can't find anywhere that explains why.
I have constantly had my thyroid and adrenal gland checked because that could be causing some of my syptoms, but those tests always came back fine. So basically my psychiatrist just keeps giving me new medicines to try. He knows that I've been going to different specialists to try to figure out what's wrong though.
From what I've researched, fluid-filled cysts in the brain (arachnoid cysts) are formed during the first few weeks of gestation. I'm assuming that from looking at the images, he was able to tell that it was not an abcess from an infection, which would mean that it's been there since birth. However, the radiologist's report did say that a post-infectious cyst could not be excluded. I'm so confused!!
I have constantly had my thyroid and adrenal gland checked because that could be causing some of my syptoms, but those tests always came back fine. So basically my psychiatrist just keeps giving me new medicines to try. He knows that I've been going to different specialists to try to figure out what's wrong though.
From what I've researched, fluid-filled cysts in the brain (arachnoid cysts) are formed during the first few weeks of gestation. I'm assuming that from looking at the images, he was able to tell that it was not an abcess from an infection, which would mean that it's been there since birth. However, the radiologist's report did say that a post-infectious cyst could not be excluded. I'm so confused!!
Where do you live? Is it near a large hospital? Have you maybe considered seeing a neurosurgeon? I would at least call one and tell them that you are not sure if you need to make and appointment with them or a regular neurologist...I have found that this usually gets me to the person I need to see in the beginning. After watching my daughter suffer with the cysts (which turned out to be abscesses), my heart hurts for you and your parents. I am sure that it has pretty much stopped you in your tracks with the symptoms you have. It is good though to see someone who can look at your case with a fresh eye. Very smart to learn as much as you can before you go. They usually rattle off what they think and then ask if you have questions when you don't even understand what they said, let alone what to ask in the first place. But I digress, did you also look up the Virchow-Robin spaces? I did not know the significance of their size in someone your age so did a search. There are several good articles that explain pretty clearly so that you can ask about them. Also, have they looked for anything else to explain your symptoms or just put you on antidepressants and sent you home? And wouldn't they be depressed if they felt the way you do and for so long?
I am curious, how did they know you have had it since birth? Have you had an MRI before so that they have a comparison? When is your appointment? I truly hope that you find an answer and a treatment that can get you going again. If for some reason this doctor cannot figure out the problem, you might consider looking into a teaching hospital at a university. Let us know how you are doing and let me know if I can look anything up for you and email it to you. Take care and God Bless.
I am curious, how did they know you have had it since birth? Have you had an MRI before so that they have a comparison? When is your appointment? I truly hope that you find an answer and a treatment that can get you going again. If for some reason this doctor cannot figure out the problem, you might consider looking into a teaching hospital at a university. Let us know how you are doing and let me know if I can look anything up for you and email it to you. Take care and God Bless.
Thank you both so much for responding!!
My symptoms have been so severe over the past 4 years (mostly the fatigue and psychiatric problems and headaches) and then with the left-sided numbness/weakness that started recently (as well as even more increased fatigue), I can't believe that it's been so difficult for the doctors to find what's wrong.
I saw my neurologist who ordered the MRI (as well as an EEG and some blood work), and I saw him to go over those results. He told me that I had a congenital cyst in my brain, but that since I've had it since birth, it's fine. That's it.
When I got home I decided to get a copy of the MRI report from the radiologist so that I could see what they wrote about the cyst. 3.5mm is very small, but I want to know if it is possible that it is in a spot that is causing my symptoms.
I have done some research at the health library at the hospital and everything I have read about brain cysts says that they are definitely not good and that they need to be continually watched to make sure they don't enlarge. I also found a source that said if the cyst has been present since birth, symptoms tend to develop in adolescent and young adult years.
My neurologist just kind ignored the whole situation. I am definitely going to a second neurologist with the MRI reports to get another opinion, but until that appointment, I'm trying to do as much research as I possibly can so that I can be prepared with questions.
My parents and I are losing patience because no one can seem to find what is wrong with me.
My symptoms have been so severe over the past 4 years (mostly the fatigue and psychiatric problems and headaches) and then with the left-sided numbness/weakness that started recently (as well as even more increased fatigue), I can't believe that it's been so difficult for the doctors to find what's wrong.
I saw my neurologist who ordered the MRI (as well as an EEG and some blood work), and I saw him to go over those results. He told me that I had a congenital cyst in my brain, but that since I've had it since birth, it's fine. That's it.
When I got home I decided to get a copy of the MRI report from the radiologist so that I could see what they wrote about the cyst. 3.5mm is very small, but I want to know if it is possible that it is in a spot that is causing my symptoms.
I have done some research at the health library at the hospital and everything I have read about brain cysts says that they are definitely not good and that they need to be continually watched to make sure they don't enlarge. I also found a source that said if the cyst has been present since birth, symptoms tend to develop in adolescent and young adult years.
My neurologist just kind ignored the whole situation. I am definitely going to a second neurologist with the MRI reports to get another opinion, but until that appointment, I'm trying to do as much research as I possibly can so that I can be prepared with questions.
My parents and I are losing patience because no one can seem to find what is wrong with me.
Did a neurologist order the test? Have they done nothing about it or did someone give you a copy of the report and you will find out later? You should call the doctor that ordered it and insist that you be referred to someone who will follow up. It would not be of so much concern if you did not continue to have symptoms and you cannot assume anything until the doctor tells you they are not connected. I would contact a neuro doctor on my own if not referred. My daughter (two at the time) went undiagnosed with symptoms that included such severe headaches that she had pulled part of her hair out, vomiting and one sided weakness, etc. I believe that the only reason they ever diagnosed her was because her regular doctor was out of town and the "on call" doctor sent her for an mri. She referred us to the neurosurgeon that identified the cysts found on the mri. It sounds as though you will have to be your own advocate so make calls and insist they give you a complete explanation. If you do not get a straight answer from one, go somewhere else until you are satisfied that you know what is wrong and what, if anything can be done about it. Please let us know how you do. Take care and God Bless.
Your ordering doctor has to discuss with you what the results mean on mri.. The question is whether the mri has anything to do with your symptoms. My daughter is going through a similar thing except her mri is different from yours. It is still abnormal and cant be explained.
I would like to know more about the symptoms and what your doc thinks about all this. I have written in the forum twice recently maybe you can find them to see if you can relate to what my daughter is going through.
I would like to know more about the symptoms and what your doc thinks about all this. I have written in the forum twice recently maybe you can find them to see if you can relate to what my daughter is going through.
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