Cerebrospinal fluid is a transparent fluid that encloses the brain and spinal cord. It provides cushioning effect and prevents injury. It also helps in nutrient delivery and aids in waste removal. Analysis of the CSF helps diagnose infectious diseases of the brain and spinal cord, autoimmune disorders, bleeding disorders in the brain, and brain tumors.

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My mom's health got worse after anaplastic astrocytoma treatment. Why?

Query: Hi doctor, Four years ago, my mom was diagnosed with an anaplastic astrocytoma in the right parieto-occipital region. She underwent radiotherapy and chemotherapy with Temozolomide, which shrunk the lesion. Over the years her mobility has declined significantly. She can only walk a few steps with sup...  Read Full »

Dr. Hardik Nareshbhai Rajyaguru

Answer: Hi, Welcome to icliniq.com. I understand your mom's case. The most likely reason for her loss of consciousness would be a microscopic spread of the tumor to the areas of the brain which control consciousness.The spread cannot be detected on an MRI (magnetic resonance imaging). The only way to diagno...  Read Full »

Why is there a muscle tension in my shoulders, arms, and hands?

Query: Hello doctor, I have problems with clear thinking. When I am in a wrong position, there will be tension in my shoulders and arms, and in my face muscles, but also I cannot think clearly anymore. It is like a blackout. When I bend my head forward for a few seconds, my body reacts with sweating, rapid...  Read Full »

Dr. Solanki Chirag Natwarbhai

Answer: Hello, Welcome to icliniq.com. I have gone through the attachments (attachments removed to protect patient identity). From your complaints, it looks like you are having tension type of pain. Actually, it occurs because of tensed tightened neck muscles. Some patients also feel similar pain in te...  Read Full »

What can be the white hyperintensities on MRI?

Query: Hello doctor, I am a 39-year-old female who is otherwise healthy. I recently had an MRI due to smelling smoke. Some white hyperintensities were found on the MRI. As a result, I had a lumbar puncture. Everything came back normal, no oligoclonal banging was present. However, my IgG synthesis rate appe...  Read Full »

Dr. Aida Abaz Quka

Answer: Hello, Welcome to icliniq.com. The increase of protein (IgG and albumin) production in the LCS (liquide cerebro-spinal) could be related to different chronic neurological disorders like an autoimmune disorder, a chronic infection like Lyme disease, multiple sclerosis (MS), etc. Although the presen...  Read Full »

Which is a better treatment for NPH, shunt surgery or CSF drainage?

Query: Hello doctor, My 76 year old mother was recently diagnosed with normal pressure hydrocephalus. She is having trouble walking. She can walk only three to four steps at a time. She has been having this difficulty since a month now. She is currently not on any medication for this or for any other issu...  Read Full »

Dr. Chandan Mohanty

Answer: Hello, Welcome to icliniq.com. I am sorry to hear about your mother. I have seen her MRI reports (attachment removed to protect patient identity). Going for lumbar puncture (LP) drainage, and then checking for a clinical improvement, before a shunt, has a better chance of determining the overal...  Read Full »

Why did my doctor ask for a signature before undergoing LP?

Query: Hi doctor,My question regarding the LP test of the backbone. Why the doctors want my signature for this test? Is there any major risk or side effect in this procedure? The test showed 5 x 5 rings in the brain and rest everything is normal. There is no previous medical history other than a headache,...  Read Full »

Dr. Hitesh Kumar

Answer: Hi, Welcome to icliniq.com. Lumbar puncture is done to collect CSF (cerebrospinal fluid, the fluid surrounding the whole brain). Possibly they will send that fluid for tests to search the reason for rings in the brain. Ring enhancing lesions in the brain can be due to many reasons like tuberc...  Read Full »

I had surgeries for cauda equina syndrome. Can you decode the surgery notes?

Query: Hello doctor, I recently had two spinal surgeries for cauda equina syndrome. I was told that a second surgery was required due to a dural tear. However, on reading my clinical notes, I now question this. I have the operation notes, which I can send (about a paragraph each) if you have a spinal surge...  Read Full »

Dr. J. Mariano Anto Bruno Mascarenhas

Answer: Hello, Welcome to icliniq.com. I have gone through your query with diligence and would like you to know that I am here to help you. Can you please elaborate on what your question is?  Read Full »

What is mega cisterna magna, and what is the significance?

Query: Hi doctor, Can you please review my MRI scan and check if everything is normal, and is there anything to worry about?  Read Full »

Dr. Hitesh Kumar

Answer: Hello, Welcome to icliniq.com. Your MRI (magnetic resonance imaging) report (attachment removed to protect the patient's identity) shows most structures visible within normal limits except incident mega cisterna magna. Cisterna magna is a normal CSF (cerebrospinal fluid) filled space on the...  Read Full »

Can SSPE (subacute sclerosing panencephalitis) be cured?

Query: Hi doctor, I am the father of a 5-year-old daughter. She is a very energetic, lively, talkative, and intelligent girl. Two months back, we noticed she frequently falls while running and having a minor issue with her studies. We consulted a pediatrician, and he suggested some vitamins. However, the ...  Read Full »

Dr. Upendra Kumar Shah

Answer: Hi, Welcome to icliniq.com. By inspecting the reports (attachments removed to protect patient's identity), it seems this is a case of SSPE (subacute sclerosing panencephalitis) due to measles, a kind of virus that is slowly growing in the brain causing all these symptoms. Unfortunately, there is n...  Read Full »

What does arachnoid granulation on an MRI scan mean?

Query: Hi doctor, I had an MRI scan completed on my head privately due to having headaches, and I have received the report and do not understand it, and it is really worrying me. Report: No signal abnormality. No space-occupying lesion. Adjacent to the right transverse sinus, there is a focal lesion o...  Read Full »

Dr. Aida Abaz Quka

Answer: Hi, Welcome to icliniq.com. I read your MRI report carefully and would explain that it shows nothing serious, just a mild birth abnormality, some brain tissue in the wrong place (misplaced during brain formation). But you have been living with that for your entire life, and it does not cause any s...  Read Full »

Why is there constant headache for over five years?

Query: Hello doctor, I have been suffering from a constant headache for over five years. An MRI done roughly 2 to 3 years ago showed pineal cysts but the report stated they were of no significance. Since then further investigations have been done to find the cause of my headaches. A neurologist I was seei...  Read Full »

Dr. Prakashkumar P Bhatt

Answer: Hello, Welcome to icliniq.com. I am fine. Through your case summary, you are suffering from persistent daily headache which is disabling your daily activities. You were completely evaluated for your headache initially where MRV showed left transverse sinus stenosis 2 to 3 years ago. CFS pressure w...  Read Full »

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