2019 Neurosurgery Follow-Up

Gracious!

So, I had my MRI in early May this year, but didn’t have my follow-up appointment with the neurosurgeon’s office until yesterday. The radiologist’s report from the MRI said some worrisome stuff:

Study Result

Impression

IMPRESSION:

Status post prior left frontal temporal craniotomy for left petroclival tumor

resection. Since the MRI of 6/5/2018, apparent slightly increased enhancement 

within the resection cavity at the junction of the petroclival junction. This

could either reflect early recurrence versus postsurgical granulation tissue.

Surrounding marrow signal and enhancement around the resection cavity is 

similar. Consider attention on the next follow up to reassess for changes.

Narrative

EXAMINATION:

MRI BRAIN WO/W CONT

CLINICAL INDICATION:

MRI brain w/wo contrast. Eval for tumor recurrence, S/P resection of left

sided petrosal & cavernous sinus chondrosarcoma. 1yr f/u

TECHNIQUE:

MRI Head without and with contrast: Extra-Axial Tumor B-2EA

Non-contrast : Axial T1, T2, FLAIR, DWI

Post-contrast: Sagittal T1, Axial and Coronal T1 fat sat

CONTRAST:

Prohance 16 ml 05/08/2019 08:54 AM INTRAVENOUS

COMPARISON:

Brain MRI of 6/5/2018, 6/6/2017, 6/7/2016, and dating back to at least

3/9/2015.

FINDINGS:

Status post prior left frontal temporal craniotomy for left petroclival tumor

resection. Since the MRI of 6/5/2018, there is apparent slightly increased

enhancement within the resection cavity at the junction of the petroclival

junction. Surrounding marrow signal and enhancement is similar.

No acute ischemia or intracranial hemorrhage.

No pathologic intracranial enhancement.

The ventricles, sulci, and cisterns are within normal limits.

There is similar nonspecific scatter periventricular and subcortical white 

matter T2/FLAIR hyperintensity, possibly related to chronic ischemic small 

vessel disease changes versus posterior mass effect.

The extracranial structures are unremarkable.

ATTENDING RADIOLOGIST AND PAGER NUMBER

8900 SHIBATA DEAN KAZUO MD

(206)982-6606

Component Results

There is no component information for this result.

General Information

Collected

05/08/2019 9:05 AM

Resulted

05/08/2019 12:53 PM

Ordered By

Jennifer R Minor, ARNP

Result Status

Final result

This was different than what the previous MRI reports had said. It looked a little worrisome, and I had a lot of questions. I decided to do some homework, write down the questions, and wait ’till the neurosurgery appointment to see what they’d say rather than get too worried about it.

That was a good move…

It turns out the nonspecific periventricular and subcortical white matter T2/FLAIR hyperintensity is something that’s been there since before the surgery and “that’s just what some people’s brains look like”.

Also, it seems that the slightly increased enhancement within the resection cavity is so slight that it’s probably just an indicator of the normal healing process and definitely isn’t anything to worry about. Per the notes, it represents: “stable post surgical changes, no concern for recurrent or new disease”.

Whew!!!

That one was a bit nerve-wracking.

 

Leave a Reply

Your email address will not be published. Required fields are marked *