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May 19, 2009 - 2 comments
So I had a quick thought (and it has to be quick since I need to start studying for a midterm that's happening in three hours). My pineal cyst is fairly large. What if it isn't a "cyst" and something happened...the thing that showed up in my CT scan in my pons (they claim it's an artifact but they weren't sure--neither the junior nor the senior radiologists reading my file). I found a brief mention of this in a medical article online:
"Drop metastases from tumors in the pineal region are not rare [3], but if they involved the pons, they would more likely result in defects of cranial nerves V–VIII." (http://www.ajronline.org/cgi/content/full/186/3_Supplement/S224)
Please note that the sensory nerves involved in swallowing are:
* Trigeminal (cranial nerve V)
* Facial (cranial nerve VII)
* Glossopharyngeal (cranial nerve IX)
* Vagus (cranial nerve X)
(http://stroke.about.com/od/supportgroups/qt/CNSwallowing.htm)
I hope having a TIA (if it was ever a TIA) didn't cause damage to my swallowing abilities. But this is just getting ridiculous. I'm tired of having a feeling of a lump in my throat...and difficulty swallowing and breathing normally. Sometimes, I even forget to breathe.
By the way, my dentist said he felt a swollen lymph node under my chin on the left side. I KNEW there were some swollen ones there!!!!! My stupid GP wouldn't listen to me, though. Argh!!!
Interesting. I'm becoming ever-more suspicious of my pineal cyst since my pupils are now pretty dilated (cranial nerve III) in normal lighting (it hurts to walk outside more so than it ever has before...and I used to consider myself to be photosensitive before!), and I still have problems with balance. Not to mention headaches that just never seem to go away...they definitely aren't migraines, and they aren't daily headaches because I feel a lot of pressure with them and sometimes sharp pains. Pressure is a big problem for me, though.
Some other good articles I'm reading through about pineal "cysts" (they aren't all about cysts, oh well) and the problems they cause:
--http://www.ncbi.nlm.nih.gov/pubmed/16791430
--http://books.google.com/books?id=c3I-PFkMN2YC&pg=PA900&lpg=PA900&dq=cranial+nerve+pineal&source=bl&ots=o2CCCG5AmA&sig=0TiZmVhOAtfctT6ijrY-Ee-Nn_Y&hl=en&ei=SPkSSpPqCuHgtgehgumWBA&sa=X&oi=book_result&ct=result&resnum=4 (says that pineal tumors cause problems with upward gaze...which I have...and absence of pupillary light reflection, which I am only now noticing)
As much as I want this thing out of my head, this phrase makes my blood run cold: "Removal of pineal region tumors is associated with high mortality and morbidity." =(
(http://neurosurgery.dergisi.org/pdf/pdf_JTN_102.pdf)
"Drop metastases from tumors in the pineal region are not rare [3], but if they involved the pons, they would more likely result in defects of cranial nerves V–VIII." (http://www.ajronline.org/cgi/content/full/186/3_Supplement/S224)
Please note that the sensory nerves involved in swallowing are:
* Trigeminal (cranial nerve V)
* Facial (cranial nerve VII)
* Glossopharyngeal (cranial nerve IX)
* Vagus (cranial nerve X)
(http://stroke.about.com/od/supportgroups/qt/CNSwallowing.htm)
I hope having a TIA (if it was ever a TIA) didn't cause damage to my swallowing abilities. But this is just getting ridiculous. I'm tired of having a feeling of a lump in my throat...and difficulty swallowing and breathing normally. Sometimes, I even forget to breathe.
By the way, my dentist said he felt a swollen lymph node under my chin on the left side. I KNEW there were some swollen ones there!!!!! My stupid GP wouldn't listen to me, though. Argh!!!
Interesting. I'm becoming ever-more suspicious of my pineal cyst since my pupils are now pretty dilated (cranial nerve III) in normal lighting (it hurts to walk outside more so than it ever has before...and I used to consider myself to be photosensitive before!), and I still have problems with balance. Not to mention headaches that just never seem to go away...they definitely aren't migraines, and they aren't daily headaches because I feel a lot of pressure with them and sometimes sharp pains. Pressure is a big problem for me, though.
Some other good articles I'm reading through about pineal "cysts" (they aren't all about cysts, oh well) and the problems they cause:
--http://www.ncbi.nlm.nih.gov/pubmed/16791430
--http://books.google.com/books?id=c3I-PFkMN2YC&pg=PA900&lpg=PA900&dq=cranial+nerve+pineal&source=bl&ots=o2CCCG5AmA&sig=0TiZmVhOAtfctT6ijrY-Ee-Nn_Y&hl=en&ei=SPkSSpPqCuHgtgehgumWBA&sa=X&oi=book_result&ct=result&resnum=4 (says that pineal tumors cause problems with upward gaze...which I have...and absence of pupillary light reflection, which I am only now noticing)
As much as I want this thing out of my head, this phrase makes my blood run cold: "Removal of pineal region tumors is associated with high mortality and morbidity." =(
(http://neurosurgery.dergisi.org/pdf/pdf_JTN_102.pdf)
> "Removal of pineal region tumors is associated with high mortality and morbidity."
hi. Out of curiosity, I took a look and it's possible that's not true anymore. I realize your entry is a year old, and you likely have come across the same info as I, but I'll just post this here in case anybody else comes along. I don't mean to be stepping on your toes, sorry if I give that impression :)
http://www.google.com/search?q=Removal+of+pineal+region+tumors+is+associated+with+high+mortalityand+morbidity
just looking at the small quotes on that results page, it seems like maybe since the late 19802 the situation has changed and high morbidity/mortality no longer exists because of improved techinques?
Also an individual page as one example:
http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T5F-3VXR9PH-13V&_user=10&_coverDate=07/31/1997&_rdoc=1&_fmt=high&_orig=search&_sort=d&_docanchor=&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=66f719afad9880b821138003be76483e
Clinical Neurology and Neurosurgery
Volume 99, Supplement 1, July 1999
"A total of 10 tumors were resected with occipital transtentorial approach in 4 patients, parieto-occipital transcallosal approach an infratentorial supracereballar approach in 3 patients each. Total removal was achieved in 6 patients (60.0%), subtotal removal in one patient (10.0%) and partial removal in 3 patients. The morbidity was negligible since the complications resolve postoperatively in one to two weeks. There was no mortality in our series."
I could be way off base, this was just a quick look :)
hi. Out of curiosity, I took a look and it's possible that's not true anymore. I realize your entry is a year old, and you likely have come across the same info as I, but I'll just post this here in case anybody else comes along. I don't mean to be stepping on your toes, sorry if I give that impression :)
http://www.google.com/search?q=Removal+of+pineal+region+tumors+is+associated+with+high+mortalityand+morbidity
just looking at the small quotes on that results page, it seems like maybe since the late 19802 the situation has changed and high morbidity/mortality no longer exists because of improved techinques?
Also an individual page as one example:
http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T5F-3VXR9PH-13V&_user=10&_coverDate=07/31/1997&_rdoc=1&_fmt=high&_orig=search&_sort=d&_docanchor=&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=66f719afad9880b821138003be76483e
Clinical Neurology and Neurosurgery
Volume 99, Supplement 1, July 1999
"A total of 10 tumors were resected with occipital transtentorial approach in 4 patients, parieto-occipital transcallosal approach an infratentorial supracereballar approach in 3 patients each. Total removal was achieved in 6 patients (60.0%), subtotal removal in one patient (10.0%) and partial removal in 3 patients. The morbidity was negligible since the complications resolve postoperatively in one to two weeks. There was no mortality in our series."
I could be way off base, this was just a quick look :)
Hi, and thanks for your post! You could definitely be right--I got my data from a journal article, the date of which I don't remember. While surgery in that region of the head may no longer be associated with high morbidity and mortality, I know it is still one of the more dangerous surgeries a neurosurgeon can perform just given the location of the pineal gland and its proximity to vital structures, such as the occipital lobe, which controls your ability to see. It also depends on what method the surgeon uses. An actual craniotomy increases the chances of infection tenfold, while a needle biopsy or drainage of a cyst is much less invasive, although still brain surgery.
I guess I'm open to the idea of brain surgery if I need it and/or it will actually help me resolve a lot of my symptoms, but at this point in time, my neurologist appears to be avoiding any discussion of this cyst being the cause of my problems. He avoids the topic entirely, and I honestly think it is because there's no easy solution to the problem if the problem is the cyst. He could either tell me to deal with my symptoms, some of which are rather dangerous (mini-strokes, nerve damage in my head and neck, vision problems), or send me to a neurosurgeon to explore options for draining or removing the cyst, which might be even more dangerous than leaving it alone. It's a crappy situation any way you look at it...because even if the cyst isn't the cause of my problems, then I'm still back to square one...not knowing what's wrong with me, but having a lot of specialists agree that there IS something wrong.
Thanks again for your thoughts; I really appreciated it and I welcome any future information or ideas you might have. =)
-Julia
I guess I'm open to the idea of brain surgery if I need it and/or it will actually help me resolve a lot of my symptoms, but at this point in time, my neurologist appears to be avoiding any discussion of this cyst being the cause of my problems. He avoids the topic entirely, and I honestly think it is because there's no easy solution to the problem if the problem is the cyst. He could either tell me to deal with my symptoms, some of which are rather dangerous (mini-strokes, nerve damage in my head and neck, vision problems), or send me to a neurosurgeon to explore options for draining or removing the cyst, which might be even more dangerous than leaving it alone. It's a crappy situation any way you look at it...because even if the cyst isn't the cause of my problems, then I'm still back to square one...not knowing what's wrong with me, but having a lot of specialists agree that there IS something wrong.
Thanks again for your thoughts; I really appreciated it and I welcome any future information or ideas you might have. =)
-Julia
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