Strange MRI

[Carrol]

I got my MRI cd and the report today. I was surprised that there was sixteen images. I thought there would only be three or four. The report sounded a little strange and I  am wondering what it means. I don't see the doctor until April 15 so I have three weeks to wonder about it. Maybe someone else had this on their report or maybe it is what they usually report. The MRI says:

Left side acoustic schwannoma (I understand that ok) . The mass measures 2.0 cm x 1.6 cm x 1.5 cm and extends to within 2-3 mm of the fundus of the left IAC.  Unusual focal CSF outpouching along the inferomedial  aspect of the left middle cranial  fossa into the sphenoid bone. This could be related to bony remodeling from an arachnoid cyst. Leftward nasal septal deviation and spurring. ( I wonder if this is something unrelated?)

What in the world is a 'ARACHNOID CYST'

If anyone has any insight it would be greatly appreciated.

Thanks,
Carrol

[leapyrtwins]

My MRI CDs seem to have hundreds of images 

I'm not good at interpreting these types of things - Steve Gerrard is usually the one who seems to be able to make the most sense of them.

I know that we've had a lot of AN patients on the Forum with arachnoid cysts.  Search on "arachnoid cyst" and you'll find multiple threads.

Jan

[jerseygirl]

Hi, Carol,

I learned a bit about arachnoid cysts when during my second surgery the second case of the day was a young girl with a giant arachnoid cyst about 5 cm. It was discovered because she was having excruciating headaches. My understanding is that many people that have them are born with them.The  cysts are usually aspirated, not removed, but only if the present a problem, just like AN.

The girl, by the way, looked perfect and her balance was much better than mine. I think you would have to consult a neurosurgeon to get an understanding what your cyst is all about. Best of luck and do not worry just yet.

             Eve

[sgerrard]

Thanks, Jan - I think. 

I have to say I haven't seen the word "outpouching" before. It has a nice ring to it. Carol, your radiologist is being thorough, as they usually are. Along with your AN, he is recording another noteworthy spot, which might be an arachnoid cyst, or the location of one in the past. The cyst gets its name from a membrane made of up many small fibers, like a spider web. They are not rare, and only sometimes cause problems. For some reason, radiologists reading MRIs also like to comment on the current condition of your nose and sinuses, even if nobody asked. The main reason they do all that is to put it all on the record, so 3 years from now, when you have another MRI, they can tell if things are new or have been there all along.

So basically you've got an AN.

Steve

[Tumbleweed]

Actually, the fundus of the IAC is the bony partition situated at the  lateral extent of the IAC and not at the top of the IAC.

Nobody can say for certain (unless they have a time machine to travel back in time to when the AN first began to grow), but typically when an AN of Carrol's size is observed to not extend quite to the fundus of the IAC, it is often assumed that the AN began in the cerebellopontine angle (CPA) -- the triangular-shaped "empty" space between the cerebellum and pons (a portion of the brainstem) -- and grew into and not out of the IAC. Not that it matters. I just find this kind of stuff fascinating. 

Best wishes,
TW

[Rivergirl]

I am a bit fascinated that we have yet another AN with a deviated septum.....there are many of us.

[Carrol]

Thanks everyone. I feel better about it. At first when it said "unusual"  for the arachnoid cyst I was a little concerned. I've decided I have enough stuff going on to be worried about it. It will all get sorted out.
Jan thanks for the suggestion of using the "search" tool. I guess I am not familiar with the site enough to moving around much and find things. I'm a bit slow minded these days (I'll just blame it on the AN). It was very helpful and it will probably save people from answering the same questions over again if I can find the answers there first.

Have an awesome day everyone.
Carrol

[sues1953]

This thread brings up some things I have been questioning.  I recently received a second opinion from Dr. Telian at U of M here in Michigan.  He questioned whether or not I even  have  an Acoustic Neuroma because, if I understood correctly, it looks like the tumor may have started in the CPA and grew into the IAC.  In that case it could be a Meningioma(the only way they can know for sure is to open your head or do a biopsy).  In my case I have good hearing on the tumor side and he suggested Retro approach to try to save my hearing.  He also suggested that an MRI of the IAC, very thin slices would help to tell (mine is of the whole brain, very thick slices).

Meningioma's don't start to grow on the hearing nerve, right?  It does seem weird to me that a tumor would grow into the IAC.

Also, When measuring a tumor, does the radiologist measure the part in the auditory Canal or not?  On my report he did not but when diagnosing me the first Dr. did.  It made a difference of 1 cm  

So for Carrol it means that she could possibly have a Meningioma, Correct?  Not that it really matters in all cases but if saving hearing is an objective it could.

Sue in Michigan

[leapyrtwins]

Jan thanks for the suggestion of using the "search" tool.

I would have given you a link to a thread on arachnoid cysts, but there are too many - about 10 or 12, I think. 

Thanks for the translation, Steve.  Have you ever considered a 2nd career as a radiologist?

Jan

[my sunshine]

I had a brain tumor and know how scary the diagnosis is and waiting 3 weeks is a long time...
From my limited experience of medical terms (although lots of experience as a patient), I believe that an arachnoid cyst is not significant.
I'd be happy to contact my surgeon in NY to get his opinion if you're interested.  I remember that the 'waiting period' was just about worse than the reality.
Take care...

[leapyrtwins]

Sunshine -

the majority of us here had/have brain tumors.  Acoustic neuromas are brain tumors.

The diagnosis is quite scary, but we're all living proof that there is life after a brain tumor 

Jan

[Tumbleweed]

He questioned whether or not I even  have  an Acoustic Neuroma because, if I understood correctly, it looks like the tumor may have started in the CPA and grew into the IAC.  In that case it could be a Meningioma...

Also, When measuring a tumor, does the radiologist measure the part in the auditory Canal or not?  On my report he did not but when diagnosing me the first Dr. did.  It made a difference of 1 cm 
Sue in Michigan

Take this with a truckload of salt, but if my memory serves me correctly around 20% of ANs begin in the CPA (I'm just not certain I remember the exact percentage).  This was the case with my AN.

Some radiologists include in their measurements that portion which is in the IAC, others don't. The 1cm difference in measurement in your case, Sue, sounds about right, as that is roughly the length of the average person's IAC.

I don't know anything about meningiomas, so I unfortunately can't answer any questions related to that.

Best wishes,
TW

[sues1953]

Thanks  TW that sounds right to me  .

Sue