Hello, My name is Shiva (basically from India) currently living in Maryland. My mom (Aged 65) had a gradual hearing loss in the last 3 yr medical history and last Nov'07 when hearing test was done, she had total 100% hearing loss on her left ear. Right ear is fine. Doctors in India confirmed this as a Menierie's disease and she should be okay with one ear (no life threating). I got her to US on a visitor visa for second opinion (with no insurance) and took her to an ENT specialist and he recommended to do an MRI. We did MRI (with/without contrast) last week and I found she has acoustic neuroma. This is what the result says (sorry for putting the long result). I have an appointment with my ENT only on 04/21/08 to discuss abt the results and so thought to have some discussions in this forum. Any suggestions/help would be really appreciated.
TECHNIQUE : The examination was performed with and without the intravenous administration of 15ml of OptiMARK contrast.
FINDINGS : There is a Large left cerebellopontine angle mass extending into the left internal auditory canal and widening the left porous acousticus, with dense enhancement, measuring 16mm AP by 22mm ML by 16mm CC, representing a left vestibular neurinoma. There is minor mass effect. The right cerebellopontine angle is clear.
Normal Cerebral hemispheres, with normal cortical gray matter and white matter tracts. There are mild white matter hyperintensitles supratentorially likely representing chronic ischemic change.
Normal Ventricles, without alteration in size of morphology.
Normal corpus callosum, with a normally developed rostrum, genu, body and splenium.
Normal septum pellucidum.
There is no extraaxial mass lesion, or fluid accumulation.
Normal bilateral basal ganglla, thalami, and internal and external capsules.
Normal sella turcica, pituitary gland, infundibular stalk, optic chiasma and hypothalamus.
Normal visualized bilateral cavernous sinuses.
Normal suprasellar, interpeduncular, and pre-pontine cisterns.
Normal enhancement of the dural sinuses and cortical veins. There is no enhancing supratentorial intra-axial or extra-axial mass lesion, or vascular malformation.
Normal midbrain, pons and medulla, without signal or morphologic alteration. Normal tectal plate. There is no enhancing abnormality of the brainstem.
Normal vermis and cerebellar hemispheres, without tonsillar ectopia. There is no enhancing abnormality of the cerebellum.
Normal flow within the carotid and vertebral arteries, without a demonstrated aneurysm or occlusion of the Circle of Wlllls.
Normal bilateral temporal bones, with normal bilateral internal auditory canals (IACs), mastoid air cells, and petrous apices. There is no enhancing abnormality of the cisternal or intracanicular portions of the bilateral 7th or 8th cranial nerves. There is no demonstrated fluid within the tympanic cavities. Normal visualized bilateral vestibula and cochlea.
Normal bilateral Meckel's cave.
Normal bilateral orbital contents, with nornal visualized bilateral intraconal and extraconal spaces, extra-ocular muscles and optic nerve sheath complexes.
Normal visualized paranasala sinuses, without demonstrated mucosal inflammatory process.
Normal clivus, without a destructive process.
Normal foramen magnum, with CSF surrounding the brainstem-cervical cord junction.
Normal anterior atlantoaxial articulation of the cervical spine.
Normal visualized central osseous skull base, without a destructive process.
Normal visualized soft tissue structures of the suprahyoid neck, at the craniocervical junction.
Normal visualized posterior nasopharynx, without a demonstrated adenoidal pad hypertrophy, retention cyst, or mass lesion.
Normal osseous calvarium, without an osseous destructive lesion.
Normal subcutaneous adipose space of the calvarium, without a demonstrated soft tissue mass lesion.
IMPRESSION : Large left probable vestibular neurinoma with minor mass effect.
Minor probable chronic ischemic changes.
Otherwise, normal MR of the brain without and with contrast. Specifically, no hemorrhage, additional mass or mass effect or infarction.
My Question :
1) Considering her age, what is the best approach? Surgery, radiotherapy?
2) Is this size life threating? Is she going to get affected in the facial nerve sooner? Since we did not take any MRI before, we do not know the growth rate...
3) Since no pre-existing conditions are covered by insurance (vistor insurance) is there any organization/charity to help us OR should we consider to get treatment in India?
I LOVE MY MOM so much and Iam the only child to her. I didn't share her MRI results with any of our family members (even my dad doesn't know). I don't know what to do. Pls. any HELP/ADVICE/SUGGESTIONS would be really appreciated. Thanks a lot. I want to save my mom.
Regards,
Shiva
