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Neurology (Expert Forum)
cortical neoplastic or dysplastic focus is possible?
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cortical neoplastic or dysplastic focus is possible?
by AslReBecca, Feb 13, 2007 12:00AM
Our son (7 years old at the time) had a possible stroke in November 2000, but too many doctors, many opinions...we were left out in the cold (information wise). This past week, we had a neurology appointment to discuss our son’s well being. We're military, so continuity of care or even meeting with a neurologist is rare.
'Fellow' stated that some of the doctors believe our son had a stroke, but some did not. There was a doppler study done that showed blood clots bouncing back and forth in the heart, but not going to the lungs at all. A hole in the heart was ruled out by a cardiologist.
'Fellow' says this is the reason that some of the docs don't believe it was a stroke. The impression is typed below, but can someone explain this to me in English, layman terms. This is an "impression" (what the document states-not me being mean) after one of our son's CAT scan.
::8 September 05-Interpretation: A single focus of cortical signal abnormality ::in the high anterior, medial right frontal lobe, adjacent to the ::interhemispheric fissure, measuring 5 mm in size. No change from 11/22/00. ::This could represent an old area of ischemic change, although the appearance ::is not that of encephalomalacia. A cortical neoplastic or dysplastic focus is ::possible.
'Fellow' stated that some of the doctors believe our son had a stroke, but some did not. There was a doppler study done that showed blood clots bouncing back and forth in the heart, but not going to the lungs at all. A hole in the heart was ruled out by a cardiologist.
'Fellow' says this is the reason that some of the docs don't believe it was a stroke. The impression is typed below, but can someone explain this to me in English, layman terms. This is an "impression" (what the document states-not me being mean) after one of our son's CAT scan.
::8 September 05-Interpretation: A single focus of cortical signal abnormality ::in the high anterior, medial right frontal lobe, adjacent to the ::interhemispheric fissure, measuring 5 mm in size. No change from 11/22/00. ::This could represent an old area of ischemic change, although the appearance ::is not that of encephalomalacia. A cortical neoplastic or dysplastic focus is ::possible.
Doctor's Answer
by CCF-Neuro-M.D.-SH, Feb 25, 2007 12:00AM
First of all, keep in mind that I am unable to diagnose you because I am unable to examine you, this forum is for educational purposes.
The impression that you have reported from the 2005 CT scan suggests that there is an area of the brain in the right frontal lobe (underneath the forehead on the right) that has abnormal signal characteristics. The possibilities for this area of abnormal signal include: 1. An old stroke (but the radiologist suggests that it does not have the typical appearance one would expect for a stroke (encephalomalacia)). 2. A tumor (neoplastic process) meningiomas are often found in this location (close to the interhemispheric fissure), but other tumors are also possible (the good news is that it has not grown in 5 years since a note was made that there was no change since the previous scan in 2000- which would suggest a slow growing/benign tumor if it is a tumor). 3. Cortical dysplasia (a dysplastic focus) is a disorganized area of cortex (brain) that is dysfunctional and can often give rise to seizures. From your description, it sounds like the fellow was describing your sons echocardiogram and the absence of a PFO (patent foramen ovale- or 'hole in the heart'). A PFO can be associated with strokes in some patients. The abnormal signal area found on the right side of your sons brain is not easy to define based on a CT scan. I would recommend getting a MRI scan with GAD contrast to further define the lesion (especially given the radiologists concern about a possible tumor).
I hope this has been helpful.
The impression that you have reported from the 2005 CT scan suggests that there is an area of the brain in the right frontal lobe (underneath the forehead on the right) that has abnormal signal characteristics. The possibilities for this area of abnormal signal include: 1. An old stroke (but the radiologist suggests that it does not have the typical appearance one would expect for a stroke (encephalomalacia)). 2. A tumor (neoplastic process) meningiomas are often found in this location (close to the interhemispheric fissure), but other tumors are also possible (the good news is that it has not grown in 5 years since a note was made that there was no change since the previous scan in 2000- which would suggest a slow growing/benign tumor if it is a tumor). 3. Cortical dysplasia (a dysplastic focus) is a disorganized area of cortex (brain) that is dysfunctional and can often give rise to seizures. From your description, it sounds like the fellow was describing your sons echocardiogram and the absence of a PFO (patent foramen ovale- or 'hole in the heart'). A PFO can be associated with strokes in some patients. The abnormal signal area found on the right side of your sons brain is not easy to define based on a CT scan. I would recommend getting a MRI scan with GAD contrast to further define the lesion (especially given the radiologists concern about a possible tumor).
I hope this has been helpful.
