Thank you Syd!
Here's a partial transcription of my MRI exam last week. It's like something from the '60s sci-fi film "Fantastic Voyage".
What concerns me the most is: "Incidental note is made of a small, developmental venous anomaly in the left frontal lobe",
which could be an indication of a potential stroke or aneurysm. At any rate, the radiologist didn't seem to be too concerned about it.
Indication: Follow-up of vestibular schwannoma.
Comparison: Multiple brain MRIs dating back to 8/17/2011 with the most recent performed on 9/13/2017.
Findings: Redemonstrated is the multilobulated, avidly enhancing left cerebellopontine angle mass with cystic components. The prepontine component measures approximately 1.8 x (CC) 1.9 (AP) x 3.8 (TV) cm (measured approximately 1.8 x 1.8 x 3.8 cm in 2017 and 1.7 x1.5 x 3.7 cm in 2011). The component at the foramen of Luschka measures approximately 1.9 x 1.7 x 1.3 cm (measured approximately 1.8 x 1.8 x 1.4 cm in 2017, 1.7 x 1.3 x 0.9 cm in 2011). Exerted mass effect and partial effacement of the left prepontine cistern and cerebellopontine angle are similar to prior.
Postoperative change of the posterior fossa is remonstrated with left cerebellar encephalomalacia, and left suboccipital craniectomy with mesh cranioplasty (I have a titanium mesh at the back of my skull).
Shunt catheter placed via the right frontal approach terminates in the anterior horn of the right lateral ventricle near the foramen of Munro, similar to the prior examinations. Small halo of T2 FLAIR hyperintense signal along the shunt tract is also similar to prior. There is no ventriculomegaly or sulcal effacement. Ventricles, sulci and cisterns appear similar to 2011.
There is no restricted diffusion, acute infarct or parenchymal hemorrhage. Incidental note is made of a small, developmental venous anomaly in the left frontal lobe.
There is no focal extra-axial collection.
There is smooth,diffuse dural enhancement.
The major vascular voids are intact.
There is minimal mucosal thickening of the paranasal sinuses with a small mucous tension cyst at the right maxillary sinus floor. Mastoid air cells are clear. Left mastoid air cells are underpneumatized.
Globes and orbits appear normal.
Nasopalatine duct cyst is remonstrated.
Impression:
1. Left cerebellopontine angle mass presumed to reflect vestibular shwannoma is similar to 2017. When compared to the more remote examination from 2011, there has been slight, gradual increase in size.
2. Smooth, diffuse dural enhancement most likely reflects intracranial hypotension (overshunting). Shunt catheter tip location, ventricles, sulci and cisterns appear similar to 2011.
