HomeAnswersNeurologyheadacheWhat does arachnoid granulation on an MRI scan mean?

I had an MRI scan of my head due to having headaches. Kindly interpret my reports.

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

Dr. Chithranjali Ravichandran

Published At April 26, 2021
Reviewed AtApril 26, 2021

Patient's 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 of predominantly CSF signal, but some central T2 isointensity. This is likely to represent an arachnoid granulation.

No evidence of hemorrhage. No restriction of diffusion.

Opinion: Likely incidental transverse sinus arachnoid granulation. A contrast study would confirm.

Is this serious?

Many thanks.

Answered by Dr. Aida Abaz Quka

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 symptoms. So, there is nothing to worry about. I hope you will find this information helpful.

I remain at your disposal for any further questions whenever you need them.

Kind regards.

Patient's Query

Hi doctor,

Thank you for the above answer.

Can you please explain what the following are of the report?

Focal lesion of predominantly CSF signal, but some central T2 isointensity.

Arachnoid granulation.

Why have they recommended a contrast study if it is nothing?

As when I checked online the above, they seem to say they can be something serious, but from your reply early, you would seem to think differently?

Many thanks in advance.

Answered by Dr. Aida Abaz Quka

Hello,

Welcome back to icliniq.com.

A focal lesion with a CSF signal means that there is a brain formation similar in intensity with cerebrospinal fluid. This is typical of arachnoids granulation, but only contrast would help determine its nature for sure. That is why they have recommended another MRI with contrast enhancement. Anyway, this is just to confirm that it is arachnoid granulation for sure, which is quite a benign lesion. Arachnoid granulations are structures filled with cerebrospinal fluid (CSF) that extend into the venous sinuses through openings in the dura mater and allow the drainage of CSF from subarachnoid space into the venous system. Usually, they are asymptomatic but can be symptomatic when large enough to cause sinus occlusion. Now returning to your MRI, there is no sign of increased Cerebrospinal fluid pressure or sign of compression.

So, in my opinion, this is just an incidental finding.

I would recommend follow-up with another MRI after a year in order to see if it will get bigger or not.

In the meantime, I would recommend avoiding contrast MRI because of possible adverse effects related to the contrast and because I think that this is not really necessary.

I hope you will find this information helpful.

We wish you all the best.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Aida Abaz Quka
Dr. Aida Abaz Quka

Neurology

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