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Neurology (Expert Forum)
Pineal Brain cyst/tumor
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Pineal Brain cyst/tumor
by cmb123070, Oct 25, 2005 12:00AM
In September 2003 I was diagnosed with a pineal brain cycst, measuring 2cm x 1.5cm x 1cm. I have had 4 separate MRI's since them. In the previous 3 MRI's there was no change in the size of the cyst.
I just got the report back on the fourth MRI, which was done on 10-21-05. The cyst is now measuring 2.8cm x 1.6 x 1.2
The report reads "Since 12/8/03, a cystic lesion in the region of the pineal gland has slightly increased in size and it has lobulated or multiseptated appearance which is unchanged. No peripheral or internal enhancement. Most likely this is either a pineal cyst or pineal cytoma although findings are non-specific. No hydrocephalus. Follow-up as clinically indicated."
I am waiting for an appt with my neurosurgeon, but wondered what the above means. I am mostly concerned with the words lobulated and multiseptated.
I also recently began experiencing "floaters" and saw an opthamologist. He said my retna and pressure looked good. I am waiting for an appt for a "vision fild".
My report also reads "This lesion is of slightly lower signal intensity than gray matter on diffusion weighted images". What does that mean? It's like reading a foreign language.
The cyst is also flattening my tectal plate.
Any info you can give me on this report would be greatly appreciated. Thank you!
I just got the report back on the fourth MRI, which was done on 10-21-05. The cyst is now measuring 2.8cm x 1.6 x 1.2
The report reads "Since 12/8/03, a cystic lesion in the region of the pineal gland has slightly increased in size and it has lobulated or multiseptated appearance which is unchanged. No peripheral or internal enhancement. Most likely this is either a pineal cyst or pineal cytoma although findings are non-specific. No hydrocephalus. Follow-up as clinically indicated."
I am waiting for an appt with my neurosurgeon, but wondered what the above means. I am mostly concerned with the words lobulated and multiseptated.
I also recently began experiencing "floaters" and saw an opthamologist. He said my retna and pressure looked good. I am waiting for an appt for a "vision fild".
My report also reads "This lesion is of slightly lower signal intensity than gray matter on diffusion weighted images". What does that mean? It's like reading a foreign language.
The cyst is also flattening my tectal plate.
Any info you can give me on this report would be greatly appreciated. Thank you!
Doctor's Answer
by CCF-Neuro-M.D.-PW, Oct 27, 2005 12:00AM
THe report contains language that is meant for a medical professional, hence it seems like a 'foreign language' to laypeople!
Although the measurement has increased it is a minimal and probbaly insignificant change, there is also difference attributable to a different person measuring it a bit differently etc
lobulated and multispetated are just descriptive terms about its appearance meaning that the cyst (a fluid collection surrounded by a lining) also has some lining within the cyst dividing it up a bit, something that occurs with many cysts. The intensity is just a descriptive term regarding the color of the cyst - that it darker compared to another area, also consistent with the fact that fluid on this type of scan (ie fluid in the cyst) normally apeears darker than solid material
The flattening of the tectal plate means that there is some pressure on the part of the brain below the cyst - I cannot tell how bad from the internet, some symptoms that could occur if significant would be vertical double vision, persistent headache, jerky eye movements, but probably not just 'floaters'
Good luck
Although the measurement has increased it is a minimal and probbaly insignificant change, there is also difference attributable to a different person measuring it a bit differently etc
lobulated and multispetated are just descriptive terms about its appearance meaning that the cyst (a fluid collection surrounded by a lining) also has some lining within the cyst dividing it up a bit, something that occurs with many cysts. The intensity is just a descriptive term regarding the color of the cyst - that it darker compared to another area, also consistent with the fact that fluid on this type of scan (ie fluid in the cyst) normally apeears darker than solid material
The flattening of the tectal plate means that there is some pressure on the part of the brain below the cyst - I cannot tell how bad from the internet, some symptoms that could occur if significant would be vertical double vision, persistent headache, jerky eye movements, but probably not just 'floaters'
Good luck
Everything I have read on surgeries in that area of the brain tell of how risky it is. I am glad to hear your wife is doing well.
Surgery always has it's risks. The approach they take to get to the pineal region is from the base of the scull just above the neck. They put you in a position with your chin rolled down to your chest. This view provides a direct view of the area without having to move any parts of the brain out of the way. Unfortunatly my wife had difficulty due to her large chest. Basically the surgen stopped the procedure after 4 1/2 hours due to problems with her breathing. The second time, they went in from the side above and behind the right ear. There are more complications with this route because they have to lift up the part of the brain that processes the vision and it does not provide as good a view to the pineal area. It was about a week before her vision was normal.
Another important thing to keep in mind if surgery is decided is to find a surgen that has done this procedure more than once. The ricks are lower when you have a surgen that has done this procedure. You will not find a surgen that specializes in the pineal cyst. The surgens that do this work are usually specialist in brain tumers. My wife's surgen does approx. 250 tomur surgeries a year. Of those only 5-6 are in the pineal area. I will check back if you have any more questions.
Recently I have been having vision problems, specfically "floaters" and times when I have a hard time focusing (I guess that would be double vision). It comes and goes though and is not constant. I had an eye exam done that checked my retina, eye pressure and cornea & vision. It all checked out ok, but my neuro-surgeon wants a vision field done & I am awaiting my appt on that.