Patient's Query
Hello doctor,
I would like your opinion regarding the attached CT scan of my head. I specifically want to know if you see any indication of a meningioma in the left posterior parietal lobe.
I would also appreciate your opinion on whether a CT without contrast would be able to detect this particular anomaly. Will a 0.393-inch meningioma grow so rapidly?
It was not there when I took a CT scan three years ago. I am waiting for your evaluation of this CT.
Thank you in advance.
Hello,
Welcome to icliniq.com.
I have seen the MRI (attachment removed to protect patient identity). I see a spot of hyperdensity in the left posterior parietal lobe. However, the findings are not suggestive of a meningioma. The hyperdensity may represent calcification due to a granuloma. I suggest you do an MRI (magnetic resonance imaging) of the brain with good contrast to confirm the findings. A granuloma represents a dead infection and usually does not need treatment.
To answer your other question, a 0.393-inch meningioma developing over less than three years is significant and needs to be investigated and possibly resected.
I hope this answers your query.
Thank you.
Patient's Query
Hi doctor,
Thank you for the useful information. That CT (Computed Tomography) was taken three years back after I hit my head, which was unrelated to this current month's findings of a 1 cm meningioma. I had forgotten that I had this study, that is why I reached out for another opinion. I visited a neurosurgeon this morning, who feels that the tumor is too small to be removed and should be watched. I, on the other hand, feel that this amount of growth is drastic since the tumor was not there that time. The doctors did use contrast in the most recent MRI that was done this month. Is GD (Gadolidium)a specific type of contrast or is it all the same?
Hi,
Welcome back to icliniq.com.
GD (Gadolinium) is the same contrast used in all MRIs. Although the growth of 1 cm in the last 2 to 3 years is significant, I agree with the neurosurgeon that one needs to watch it with repeat MRI after six months or a year.
If the lesion shows growth, it needs to be treated. Another thing, one needs to be sure that it is most likely to be a meningioma and not some other tumor that is more aggressive. If one is reasonably sure that the lesion is benign, one can repeat an MRI after six months or a year, and then take a call whether to treat it or not.
I hope this information is helpful.
Please let me know if you have any further questions, and I would be happy to assist you.
Thank you.
Patient's Query
Thank you doctor,
I appreciate your patience with my questions. As you can imagine, I am quite concerned as this was discovered after one month of very aggressive headaches, visual disturbance, and two instances of complete memory loss. This was not an incidental finding, but yet the doctor seems to feel that this tumor is too small to cause such disturbances. I think that the brain is a sensitive organ and anything is possible. Is what you see in the previous CT something that you can coordinate with the present CT? I think perhaps it would be best if I send you the current MRI for your opinion. I thank you again in advance.
Hello,
Welcome back to icliniq.com.
I have carefully seen both the MRIs (attachment removed to protect patient identity). I believe we should only observe the lesion as of now. Surgery is, of course, possible and safe; however, the lesion doesn't seem to be the cause of your symptoms at present.
Again, I am not entirely convinced that it is a meningioma. I believe that it might also be a granuloma. Nevertheless, we need to repeat another MRI in six months to a year and look for any increase in the size of the lesion.
I would also request MRI spectroscopy of the lesion, the next time an MRI is done, to further delineate the characteristics of the lesion. Considering your headaches and visual disturbances, I would do a complete ophthalmological examination, visual acuity fields, and fundoscopy. to see if there has indeed been any visual disturbance.
If so, I would refer you to a neurologist who will investigate you further for the cause of headaches and visual loss. The lesion, meningioma or granuloma, seems to be an incidental finding.
I hope I have been of help to you.
Have a great day.
Thank you.
Patient's Query
Hello doctor,
Thank you for your reply and for the useful information. I had a normal ophthalmological exam yesterday and a peripheral field test. I would like to ask you another question, as I know that your field of practice is neurology. About one month prior to my headaches I was experiencing shortness of breath for a period of about two months. After failure to figure out what was causing this, I was sent for a chest CT. Yes, I am totally aware that I am starting to sound like a hypochondriac, I assure you, I am not. Anyhow, this test revealed several nodules ranging from 2 to 8 mm in the right upper and middle lobe. Could one thing have to do with the other? Sorry, I know that the bottom line is to wait and see, I do get that, but I have so many questions and concerns and the doctors here are too busy. I feel like a bother. Anyhow, aside from an arrhythmia (SVT) that was ablated 12 years back, I have always been a very healthy person. Any insight you may have to offer on this additional subject would be greatly appreciated.
Hello,
Welcome back to icliniq.com.
As I had said earlier, the lesion in the brain could also be a granuloma. In the presence of these nodules, it is highly likely to be a granuloma now, rather than a meningioma.The two most common granulomatous lesions are sarcoidosis and tuberculosis. You will need to consult a neurologist and a chest physician to do more tests to figure out what it is. The lesions in the chest and brain are likely to be related to each other.
I hope this information is helpful.
Please let me know if you have any further questions, and I would be happy to assist you.
Thank you.
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Answered byDr. Ambekar Sudheer
Medically reviewed byiCliniq medical review team
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