no clinical significance?

[Crys86]

What does "No clinical significance" mean on an MRI report?

[selmaS]

  Hi and welcome to the Chiari forum.

If ur MRI report said no clinical significance then the radiologist feels the cyst is not causing u ne issues...Have u been to a neurosurgeon to review this for u? Did he agree with the report? If so, take copies of the MRI and the report to a diff NS for a 2nd opinion....u know how u feel and they may have missed something....or there is something else going on and u have yet to locate it. We r not medical professionals here, this is a suport group for those with Chiari malformation, Syringomyelia and related conditions.

Good luck.

[jet765]

Wot is a 13mm arachnoid cyst indenting the anterior pole which is on the right tenporal loab which has no clinical significance !! i keep getting head aches wich can last for a couple of days thats why i had the mri now i am non the wiser !! can you help me ?

[selmaS]

  Well diff slices will give u a diff size.....it is strange, but it does happen.

[Crys86]

Thank you guys, and yeah Selma it could be that. It was just confusing because it was the MRI reports length (same radiologist). So I was just wondering if it grew or what lol :)

[linnielou232]

I live in Mi and not sure where you are from.  Here we have clinics for people who don't have the medical coverage and they go on a wage scale.  My daughter has to go and I have to say they are very respectful and very helpful.  I would look into this and see if you have one in your area which would help with your expense.  Everything will work out, it might just take you a little time.  Best of luck.
Linda :)

[selmaS]

  Many times it appears it grew and sometimes that it shrank, but in reality it can be that one Dr is measuring from a diff point, or a second set of MRI's r done of a diff slice or angle making it look like it is a diff length.

Imagine a pear upside down cut evenly into 3 slices...if u look to either side that will be approx the same size, but look to the middle slice and it can appear to have grown, so depending which slice u look at first it can grow or shrink or appear to, so it really depends on if u r looking at comparable slices....I hope u were able to follow this, I have used this analogy b4...but not sure if I am being clear tonight,..lol...

[Crys86]

I have to ask, has my Chiari moved down in less than a month? Since it was 5 and 6 mm and now it's 6 and 7mm? Is that possible? But yeah I have kept up on the forums even though I rarely post, I know the importance of an actual specialist.. it's just I'm a single mom of a 3 year old (no child support). I'm still in college and I live pay check to paycheck. I'm lucky my employer has insurance or I would be up the creek without a paddle period. I can't really afford to go out of state right now :(, nor in the foreseeable future. College eats my paychecks, along with bills and keeping my daughter with what she needs by myself. She recently had surgery so I'm still paying for that, along with her other health issues as well (she was a Preemie). So yeah, I'm pretty broke currently and can't even afford to miss work when I, myself, am sick. So it's been rough recently here.

[linnielou232]

My heart goes out to you and this flustrating journey of Chairi Dx'd.  It was stated in the past that under 5mm isn't a problem.  Mine was at 7.5 and I had 2 NS say they didn't think it was the cause of all my issues.  I finally found a NS that specialisted in this and sat down with me and explained everything to me.  Just keep being persistant and you will find the right NS for you.  Just don't give up.  You know your body and you know what is going on.  There has been so many of us that have suffered for years with this having been told. "This isn't your problem" and dx'd me with something else.  Wish you the best and you will find the right NS for you.  We are here by your side on this.
Linda :)

[selmaS]

  Well he didn't think, he didn't think to do more testing, he didn't think to listen to his patient....I could go on, but I will stop....lol....sigh.....

My herniation was 4mm and 6mm, it is not, I repeat NOT the size of the herniation, but the width and if it is creating an obstruction of CSF and how it is affecting u and ur overall health is what should be of concern, not that it is not with in the limits he "normally" chooses to do surgery....sigh.....

U may not find a Dr close to u, and may have to travel, many of us do, I did....I went out of state...

I also had a few questionable Drs that I saw, one said I did not have chiari at all, the other said I did, but it was above him, he told my PCP he was a chiari specialist....hmmmm so, I went to TCI in NY.....

U can learn a lot on this journey with chiari, and not all of us need surgery and surgery can make some of us worse, especially those that go with inexperienced Drs....I feel it is worth the wait, and the distance to travel to one that knows chiari and has the experience to really help or tell us we r not at that point yet, but r willing to do more testing to see what else may be going on to cause some of the pain and symptoms so they can try and treat those......

Third time is the charm, neway it was for me : )

[Crys86]

Yeah before I had my cervical MRI results. He pointed out the "of uncertain clinical significance" part and said I only had borderline Chiari and acted like it was nothing. He said he doesn't do surgery until it's over 8mm and mine was barely over 5. So he didn't think it was what is causing my symptoms even though, when I looked up Chiari my symptoms match it. My regular doctor is the only one that really believes my Chiari is my problem because the poor woman has tested me for everything else. She's the one that has been researching Chiari (I'm her first Chiari patient) and ordering the tests I need for it. I'm having a CINE MRI August 2, and a sleep study because I have a lot of sleeping problems (wake up a lot, insomnia, and things of that sort). Only thing that she hasn't ordered is the lumbar MRI. We just haven't found any specialists here for Chiari. I've seen two NS, the first was an, excuse me for saying it, idiot about Chiari. Told me it didn't cause headaches. The second kept pointing out uncertain clinical significance and saying according to that it wasn't my problem.

[selmaS]

  Ok of uncertain clinical significance meaning they do not know how it may be affecting u...I would imagine it may also suggest further clinical studies, as more testing is needed to know just how it is affecting u and ur overall health.

Have u been to the NS yet to see what he has to say?

[Crys86]

Okay I have both my MRI reports in front of me. I had a brain MRI without contrast on June 7, it said: "Impression: Cerebellar tonsillar ectopia. This is of uncertain clinical significance. There is extension of the cerebellar tonsils below the foramen magnum by 5mm and 6mm."

My cervical MRI I had on July 2, it says: "impression: Cerebellar tonsillar ectopia compatible with Chiari I abnormality. Cerebellar tonsils extend below the level of the foramen magnum by 6mm on the left and 7mm on the right. Indications: Chiari I Malformation."

[selmaS]

  It could also be that the Dr and radiologist were not chiari specialists...did u have a CINE MRI?

Keep in mind, u may have symptoms, but still not be a surgical candidate, this is y it is so important to rule out related issues like a syrinx, EDS...etc as many times the symptoms can be similar.

[nsalem656]

They don't know what's significiant and what's not. They should wait till the neurosurgeon decides.

[Crys86]

It was referring to my cerebellar herniation on my MRI. It says 6mm cerebellar tonsillar herniation of no clinical significance. I'm not sure of the exact wording, as I don't have the report with me right this second, I will get the report then type in the exact wording if you need. But that's why I was asking.

[selmaS]

   I am curious too, like Billy wonder what it was in reference to...can u post the whole sentence?

But Billy is right, what ever it was referring , whomever wrote the report felt it was not going to cause u an issue at this time....it is like taking note of a freckle, it is there ,but will not affect ur health....not saying it was a freckle, just something as incapable of causing an issue, but is noticeable.

[billyz123]

It usually means they found something but it's not severe enough to be causing any health issues  according to current standards of whatever... what was it in reference to?