MRI results

[mom98]

I just got a copy of my MRI report with and without contrast. It reads:
"BRAIN PARENCHYMA: There are a few tiny white matter lesions identified within the inferior frontal lobes best seen on sagittal FLAIR imaging."
"SELLA AND PITUITARY GLAND: Within the sella there is a focal area hyperintense signal prior to administration of contrast within the posterior aspect of the gland.This measures approxiamately 8mm. This poorly enhances after admiistration of contrast."
I had the MRI after complaining of headaches, blurred and double vision, pain behind the eyes, weakness, trouble concentrating, cognitive difficulty including forgetfulness and trouble speaking, tingling in right leg...Anyone know what these findings mean? Any help would be great! Thanks!!!

[mom98]

I know! I have been thinking of switching for a while. He is convenient and he knows I am a nurse, so when I self diagnosis, he is pretty good about not making me come in. BUT when I don't have much info on something, like this, he is a poor resource... Thanks again!

[rumpled]

You may want to find another PCP though eventually - you are going to need a good one if you have a pit issue. Mine is eh, but he knows my marginal immune system so he immediately zaps any illness in me AND my husband (what he gets can effect me badly) and he is pretty good at referrals (not insurance but telling me about docs) or giving me extra testing when I need it.

After all, his/her function is to put the picture together. They may not be the expert but they should not act like you are pariah!

[mom98]

Sounds like that's the way to go then. I just hate the wait! I have been constantly getting headaches and don't know if this is the cause. So I want something done soon and my PCP won't touck it...Thanks for the insight!

Shannon

[rumpled]

Endos are not listed like that (annoying!!!) so you have to look for pituitary centers.

I really do recommend a neuro-endo rather than a regular one as well, the regular ones can barely handle the dang thyroid as they pretty much push diabetes meds. Pituitary tumors are kinda complex and need special testing. When I overhear at a regular endo - they can overlook the time of testing, the fasting, the meds that can interfere etc. Plus the neuro-endo may draw there and the labs may be better - I constantly fight with the labs on getting my labs run correctly (ACTH spun immediately, iced tube etc) . Look to university centers or large centers - they will know. I have some links to pituitary sites in the health pages and a lot of them have doctor lists.

Neuros don't know pituitary. My neuro defers completely to the endo.

[mom98]

Thanks for the comments! I have appointments with a neurologist and another one with an endocrinologist. I stressed the possibility of a tumor and the office stated the endo could handle it. I have checked and none the the endos are listed as neuro-endo. Should I look for one that is a neuro-endo specifically? I just assumed the neuro could help the endo, LOL! again, yhanks for the input!
Shannon

[rumpled]

Hello!
Mom98, If you can, I would go ahead and find the neuro-endo for the pituitary as you are going to need one and they take time to get appointments as well - that way you can wait on both the neuro and neuro-endo. 8mm is still a micro-adenoma not a macro-adenona (macro would have to removed regardless of symptoms) but yours is only 2mm away from the limit. You have to realize the sella is like a little pouch - the pituitary hangs like a cherry off a stem in the pouch custom made to hold the cherry. Anything in the pouch pushing on the cherry makes the cherry mad. There just is no room! I have some links in the health pages you can look at. It all seems scary in the beginning (been there, done that) but knowledge in needed in pituitary so you know the doc is headed on the right path and not doing the big diss.

Hi Lulu... I know nothing about MS (except sometimes my neuro says *are you sure you don't have MS* like I'm supposed to know??? . Pituitary tumors are pretty common - they are in about 20% of people and sadly, the doctors tend to ignore them to the detriment to the patients. A neurologist has pretty much been trained if tiny, ignore it and pituitary tumors can be tiny but mighty or large and nasty... I had a tiny one hide for 12 years and another just ruin my entire life... or at least it seems that way...

I don't know about demyelination in the sella - never heard of it! Live and learn though... thanks for the kudos!

[Lulu54]

Hi - I just jumped forums to read your followup on the neurologist question.  I'm wondering if it isn't too soon to consider the hyperintensity in the sella  a tumor.  It is not unusual to have MS lesions of this size and the fact that it showed increase in signal after the administration of contrast may mean demyelination and not a tumor growth.  That said, I have to admit I know virtally nothing about pituitary tumors and am glad to hear you have your neurology appt already scheduled.

best, Lulu
MS forum

ps - hi Rumpled - you do a great job over here!

[mom98]

I have appointments with a neurologist in mid july and an endocrinologist the end of July. I couldn't get any sooner :( Thanks for the info, it is much appreciated! I didn't realize that 8mm would be considered on the larger side, so YIKES! But I guess considering the size of the pituitary gland it is....just didn't think that way! I am glad you said that because I was considering put off the endo for a few months and concentrating on the neuro, the lesions. So, again, thank you!

[rumpled]

The white matter lesions are a non-specific finding that has to be investigated, hopefully, by your doctor. It can be caused by many things - headaches, high blood pressure, stroke, MS - so since the list ranges from the benign to the not so good, you have to work with the doc to find the cause. But you only have a few - so the doc may or may not do much about them except keep any eye on them...

For the pituitary tumor, I suggest you seek out a pituitary endo aka neuro-endo and get the testing that you need. Your listed symptoms have a couple of hits on pituitary like headaches and cognitive issues - pituitary issues though can run the gamut though from your hands growing to fatigue to lactation to weird hair... so testing is a must. Your tumor is on the larger (but not huge) side so it needs to be watched. There is also a neuro-opthomalogist that may me helpful to you.