MRI Results & possible surgery for 6yo son

Hi, my 6 year old son had an initial brain MRI in March and is being sent for a followup MRI on the 26th of this month. The first MRI showed a lesion in the left frontal lobe and his neuro said if it's still there on the 26th, she wants us to see neurosurgery. It's frightening to say the least and it's not very reassuring that neither the neurologist nor the pediatric diagnostic neuroradiologist have ever seen a lesion present in this fashion in that area before--her words. This is coming from one of the top neuro depts in the country and one of the best ped neurorad's in the US. If someone could maybe explain what the MRI findings mean, I'd greatly appreciate it. Because, right now, I know nothing and I don't like being kept in the dark, especially with surgery looming over our heads. Thanks!

Findings: There is an ovoid sharply marginated 6 x 5 mm lesion in the deep posterior left frontal white matter, that is hyperintense on T2/FLAIR and hypointense on T1. No contrast enhancement is identified.



There is normal size and internal architecture of the hippocampi bilaterally. There is mild prominence of the right temporal horn, a normal variant. No signal abnormalities are identified. There is no evidence of cortical dysplasia or heterotopia.


Impression:

6 mm nonspecific nonenhancing ovoid lesion in the left posterior frontal lobe as described. Appearance is nonspecific; not typical for infarct, demyelination hamartoma, or posttraumatic lesion. Unlikely represents a neoplastic process. Followup MR examination in approximately 6 months time may be of help assess for stability.

[Christopher R Newey, DO]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with a doctor.

Without the ability to examine and obtain a history, I can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.

It is difficult to provide you with much more information than what you have already been told. Based on your description, it seems like the lesion follows the cerebrospinal fluid signal on MRI (bright on T2 and darker on T1). It is reassuring that the lesion is not enhancing.

Why did your son have an MRI performed? Is he symptomatic from the lesion? Was his birth complicated?

I agree that following up with the neurosurgeon is indicated.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.