hypathetical question about brain lesion

[jonathan c]

Let's say that "John Doe" has an extra-axial, unknown type osseous lesion of almost 4 centimeters wide, located outside the frontal lobe or down close to the orbit. It has not grown in the past yr. His vision remains unafected, but there is evidence of a bit of inward/upward (away from the eye) brain compression, but no midline shift or papaladema, with an otherwise normal MRI, MRA and CT with contrast.  His gait is steady, but he does have occasional bouts with symptoms of suspected CNS-vertigo and associated nystagmus.  

John Doe's complaints:

1) a constant, dull pressure headache located behind his eyes, nose, and forehead, which is strongly associated by location with a SEVERE feeling of cranial muscle stiffness all over his forehead and the top of his head.

2) chronic eyelid/eyebrow spasms

3) blocked nose/swolen turbinates, regardless of environment or the time of year (vasomotor)

4) when laying his head down on a pillow on the opposite side as the mass, he feels all the pressure from back behind his eyes and nose "transfer" to the exact location of the lesion and describes a feeling that there is something in there "buldging out" - However, this particular phenominon differs in intensity from barely noticeable to nearly unbearable from day to day.  It should be noted that when it is present, laying on the SAME side of the lesion does not produce the same "bulding" effect on the opposite side, but rather the "pressure" feeling spreads out again as it usually is.

Question. Are these symptoms of a frontal lesion? What about turbinate related? Neither?

[Margi]

Your symtoms sound just the same as mine since I had sinus surgury these symtoms are getting worse I'v been to about 4 Dr.s and they are telling me that they can't see anything this is just getting to frustrating for me. I think this has something to do with the middle turbinates but that's just my opinion.

[dimarie]

My first neurologist didnt do anything.  The 1st MRI came back with non-specific white matter and the neuro said he didn't think it was anything and if it was something,  it was in remission.  I changed neuros after nothing was done for a few months.  The 2nd neuro ordered another MRI that showed the same and requested I have a spinal tap, I did and Thank God it was negative!  So what is the white matter?  Still don't know but the neuro believes its just white spots from previous migraine headaches.

[CCF-Neuro-M.D.-PW]

Lesions of the frontal lobe may be asymptomatic. If symptomatic they may cause seizures and if on the dominant side of the brain, expressive language problems. If in the underneath part of the frontal lobe there may be personality changes, and if on the inner part of the frontal lobe there may be 'abulia' (like a lack of expression/emotion). There may also be problems with reasoning and execution of everyday tasks.

These are symptoms of a brain frontal lobe lesion.

Blocked turbinates is more of an ENT area, but they have been associated with headache.

Good luck

[Insearchofinfo]

So if you have a brain MRI and it comes back abnormal and you are told we can only wait and see if it is MS, do they do another brain MRI later and if so when to monitor or determine if there are any changes?