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Neurology (Expert Forum)
Cavernous Hemangioma - Thalmus
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Cavernous Hemangioma - Thalmus
by Amy, Dec 31, 1999 12:00AM
Dear Neurosurgery Forum Physician,
Thank you so much for having this forum. I have learned alot by reading through all the questions and answers.
I am 35 yrs old. In 10/99 I had a bleed in the Thalmus of my brain. One day I noticed the right side of my face was numb. I thought it was fatigue and ignored it. Three days later I woke up in the middle of the night and the left side of my body from head to toe felt tingly and numb. There was an ever so slight headache behind my right eye. The next day I went to the doctor who sent me to the hospital. The doctors feel it is a 2 cm cavernous hemangioma right in the Thalmus. The did an MRI and angiography. I have a repeat MRI sch. in Feb. to make sure it is not a tumor. The sensation in the left side of my body still is tingly and numb and I notice I have headaches from time to time. They want me to report any changes. Some days my left side feels more tingly than other days and I have that sort of floaty dreamy sensation I had when I had the bleed. The other thing is my short term memory seems to be affected and I am more tired than usual. I tend to make excuses like we're all tired, it's the holidays! Are these symptoms typical and do they improve? They said if I bleed again they will want to take me to surgery as my risk for death outweighs the risk for negative consequence of surgery. I understand these gps of vessels have a tend to bleed, heal and rebleed. How common is it to rebleed and does the chance of rebleed decrease with time? Also, I have no children, would pregnancy put me at risk for rebleed? Finally, I plan to move to a location about 10000 ft in elevation. Could this pose any problems? Wow, I unloaded all my questions! If you can help with any of these questions I really do appreciate it.
Again, I appreciate your forum and want to say thanks for the time and interest you give us all.
Thank you so much for having this forum. I have learned alot by reading through all the questions and answers.
I am 35 yrs old. In 10/99 I had a bleed in the Thalmus of my brain. One day I noticed the right side of my face was numb. I thought it was fatigue and ignored it. Three days later I woke up in the middle of the night and the left side of my body from head to toe felt tingly and numb. There was an ever so slight headache behind my right eye. The next day I went to the doctor who sent me to the hospital. The doctors feel it is a 2 cm cavernous hemangioma right in the Thalmus. The did an MRI and angiography. I have a repeat MRI sch. in Feb. to make sure it is not a tumor. The sensation in the left side of my body still is tingly and numb and I notice I have headaches from time to time. They want me to report any changes. Some days my left side feels more tingly than other days and I have that sort of floaty dreamy sensation I had when I had the bleed. The other thing is my short term memory seems to be affected and I am more tired than usual. I tend to make excuses like we're all tired, it's the holidays! Are these symptoms typical and do they improve? They said if I bleed again they will want to take me to surgery as my risk for death outweighs the risk for negative consequence of surgery. I understand these gps of vessels have a tend to bleed, heal and rebleed. How common is it to rebleed and does the chance of rebleed decrease with time? Also, I have no children, would pregnancy put me at risk for rebleed? Finally, I plan to move to a location about 10000 ft in elevation. Could this pose any problems? Wow, I unloaded all my questions! If you can help with any of these questions I really do appreciate it.
Again, I appreciate your forum and want to say thanks for the time and interest you give us all.
Doctor's Answer
by CCF Neuro[P] MD, RPS, Dec 31, 1999 12:00AM
Dear Amy:
Sorry to hear about your cavernous angioma, especially the location. The thalmus is the sensory regulatory pathway of the brain. So, having a hemorrhage in this area would definitely affect your sensation. As the thalmus is located near the hippocampus area where memory is generated. However, unless you are left handed, most of the written and verbal memory is located on the other side, the left hemisphere. It is not uncommon for these to bleed, and there are no predictors for this. The brain regulates its pressure and so living at 10,000 feet would not be much more of a risk then living at sea level. Pregnancy might put some added risk, but the degree of risk would be individual. It would depend on how big the angioma, the problems encountered in the pregnancy such as seizure, high blood pressure, etc, and the difficulty of delivery. Your age is also a factor, since you are alittle older. I would speak to someone who has seen the MRI, knows you, and can follow you during the pregnacy.
Sincerely,
CCF Neuro MD
Sorry to hear about your cavernous angioma, especially the location. The thalmus is the sensory regulatory pathway of the brain. So, having a hemorrhage in this area would definitely affect your sensation. As the thalmus is located near the hippocampus area where memory is generated. However, unless you are left handed, most of the written and verbal memory is located on the other side, the left hemisphere. It is not uncommon for these to bleed, and there are no predictors for this. The brain regulates its pressure and so living at 10,000 feet would not be much more of a risk then living at sea level. Pregnancy might put some added risk, but the degree of risk would be individual. It would depend on how big the angioma, the problems encountered in the pregnancy such as seizure, high blood pressure, etc, and the difficulty of delivery. Your age is also a factor, since you are alittle older. I would speak to someone who has seen the MRI, knows you, and can follow you during the pregnacy.
Sincerely,
CCF Neuro MD
The sensory changes will be your clue that something is going on with your thalmus.
CCF Neuro MD
THANKS AGAIN FOR YOUR INPUT. WILL KEEP MYSELF ALERT TO ANY CHANGES WITH SENSORY, ETC. HAPPY NEW YEAR!!!
Your are very welcome, Happy New Year to you also.
CCF Neuro MD
I am not sure what to make of your posting. Headaches can be from arachnoid cysts, if that is the type of cyst they told you that you had. If the cyst has been there your whole life (a possibility) and you didn't have headaches before the accident, then they are probably correct. It may be that you have traumatic induced migraine or headache. I would talk to your neurologist about this. Maybe a visit to a headache specialist.
Sincerely,
CCF Neuro MD
I am not sure whether gamma knife is a viable long-term option. The possible side effects likely outweigh the possible benefit of not doing the surgery. I would doubt that your cavernous angioma is something else, because very few things would look like a cavernous angiom on MRI.
CCF Neuro MD
You are welcome. Stats are just numbers generated from retrospective studies and the number do vary. However, overall the percentages are not all that high. They are in your favor of not bleeding.
Sincerely,
CCF Neuro MD