Please help me interpret this brain MRI

[Amy2]

My 49 year old husband has been dealing with tinitus for the past few months. The tinitus hs bescome worse and is more than a minor annoyance now.  He went to an ent who ordered tests including a brain MRI. The earliest appointment we were able to get with a neuro surgeon is the middle of September.  I was hoping that someone could help he interpret these findings.  My husband is being treated for high blood pressure and high cholesterol.  He did have an artificial aortic valve about 3 years ago as is taking cumidin. He also had surgery for sleep apnea about 7 years ago and is scheduled for another sleep study in two weeks.

Radiologist interpretation

Mild peripheral brain atrophy.  There are also tiny foci of increased T2 in the periventricular white matter and the left superior frontal gyrus. These findings are non-specific and do not enhance and likely reflect areas of gliosis.  They may reflect small area of demyelination or angiopathic ischemic change.  There is a 1 cm wide and 3 mm thick enhancing area on the left aspect of the falx underlying the frontal lobe.  This represents a small en plaque meningioma.  Althernatively, it may represent ossification of the falx.

[CCF-Neuro-M.D.-PW]

My advice is limited wihtout looking at the brain scan, so  I will try to help you understand the report. Mild brain atrophy may be normal for a man of his age. FOci of increased signal, depending on their appearance may be normal for age also. It sounds like their is a small meningioma (situated in the meninges, the covering of the brain, not the brain itself), a benign brain tumour, that is relatively common as we get older, and unless large and causing problems, is left alone and followed up periodically with MRI. Meningiomas commonly 'enhance' with contrast. It is probably an incidental finding. The reason why an MRI is ordered for tinnitus is to look for an acoustic neuroma - a tumor in the brainstem.

[Amy2]

We went to the neurosurgeon yesterday.  The doctor felt that the areas of atrophy where within normal for my husbands age.  The area in question is either an area of calcification or small begin tumor.  It is very small and is not causing any neurological symptoms. It is attached to the dura and has not infaltrated the brain itself.  The doctor wants to repeat the MRI in three months after the first one (it will be in Nov.) to see if the tumor has grown. If there is no change, then it will be repeated in 6 months and then once a year for the next few years. If the area is a tumor, it may in fact have been there since birth and may never grow.  If it does start to grow, he would want to remove it.  The neurosurgeon said that if it had to be removed, the time to do it is when it is still small and has not infaltrated the brain itself.

[mssixx]

A related discussion, mri was started.