About two months ago I had a bout with vertigo and dizziness.
I went to an ENT doctor who performed some tests and suggested that
I have an MRI of my brain.
Although the MRI apparently showed negative with respect to any problems
with my inner ear, etc., it did show a small bright spot in the right
frontal area. The bright spot was not (or barely) visible on the images
which were taken without GAD dye contrast. Also, the bright
spot didn't have much volume - only about 1 slice of the MRI scan.
Both the ENT doctor and the Radiologist were convinced that the spot was
not a tumor. They also were convinced that the spot was not dangerous.
However, they were unsure of the nature of the spot and sent me to a neurologist.
It is difficult to say with confidence what kind of lesion you have without actually seeing the studies that have been done. It could be a simple venous angioma or a cavernous angioma. These malformations have characteristic appearances on imaging studies that give clues as to their identity.
A venous angioma is a benign anomaly that does not need to be treated. A cavernous angioma does carry a risk of seizures and bleeding that may be significant over the course of a lifetime. When symptomatic, cavernous angiomas are best treated with surgical resection. Your symptoms do not relate to a mass of the frontal lobe, and the MRI finding is likely incidental.
Speak to your physician about the confidence they have in making a diagnosis from the MRI's that were done. If questions remain, you should consider a second opinion for a definitive diagnosis.
The neurologist examined the MRI films and told me that he was reasonably
sure that the spot represented an angioma. He described it as a "tangle"
of veins and that it probably is benign, nothing to worry about, and
possibly a congenital defect. He also indicated that doctors are seeing
more and more of these as imaging techniques get more and more sophisticated
and common. However, in order for him to better diagnose me, he ordered
another MRI taken with more and different "T" signals and also MR
I had an MRI this morning and the next Neurologist appointment. The
Neurologist told me that the same image showed up in this MRI. The
image is a small, foamy white circular area with what appears to be little
"squiggles" in it - there are no dark areas around or inside the white
area. Again, this cannot (or barely) be seen on the films with no contrast
dye. He says that his diagnosis is pretty much confirmed as an angioma
and for me not to worry about it. Although, he is going to show the pictures
to some of his colleagues for other opinions.
I have been trying to look up some information on this and have come
across http://brain.mgh.harvard.edu:100/vascintr.htm as well as this
excellent site! After reading the above information, I guess my question
is what type of angioma do I have? The paper describes 4 types -
Telangectasis, Cavernous malformations, (common) venous malformations, and
true arteriovenous malformations (AVMs) (which are kind of vasculor short-
circuits). Sounds to me like I have the common venous malformation type?
Thanks in advance for your help - and - should I see another Neurologist
for a second opinion, or should I be comfortable with what I have?
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