Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Suggest Treatment For Oligodendraglioma And Headaches
Posted on
Thu, 14 Aug 2014
Medically reviewed by
Ask A Doctor - 24x7 Medical Review Team
Thu, 14 Aug 2014
Answered on
Tue, 9 Sep 2014
Last reviewed on
Question : My Husband was diagnosed with Oligodendraglioma Grade 2 in Dec 2006.
He had Craniotomy to resect about 90%.
He's been having follow up MRI every 3 months for 2 yrs then went to 1 yr MRIs. We got the latest results today from the MRI performed on the 11-8-2014.
The report said there is a change and have advised to have a MRSpectroscopy. There is a new white spot on the T1 (3D I think it said) weighted image.
The Dr said it could be a brain bleed. I just don't understand HOW it could be a brain bleed and not be an emergency!! I think they might be reluctant to say its tumour growth? I just don't know.
He has been having quite bad headaches for a couple of months which have been treated with sandomigran and Maxalt. Guess I'm just looking for any clear answer, but with things like this I know sometimes there just aren't.
He had Craniotomy to resect about 90%.
He's been having follow up MRI every 3 months for 2 yrs then went to 1 yr MRIs. We got the latest results today from the MRI performed on the 11-8-2014.
The report said there is a change and have advised to have a MRSpectroscopy. There is a new white spot on the T1 (3D I think it said) weighted image.
The Dr said it could be a brain bleed. I just don't understand HOW it could be a brain bleed and not be an emergency!! I think they might be reluctant to say its tumour growth? I just don't know.
He has been having quite bad headaches for a couple of months which have been treated with sandomigran and Maxalt. Guess I'm just looking for any clear answer, but with things like this I know sometimes there just aren't.
Brief Answer:
Request old and current MRI report details
Detailed Answer:
Hi XXXX,
Thanks for writing in to us.
I have read through your query in detail.
Oligodendrogliomas Grade 2 are tumors which are not very aggressive but at the same time require surgery when its growth is causing pressure effects on surrounding structures. I think thats the reason why your husband had it removed 8 years back. In my experience in working with patients with oligodendrogliomas, the reurrence rate is very less and that is something which makes patients comfortable enough to try the wait and watch policy.
Coming to the present MRI dated 11-08-2014, I would like to state that there might have been certain changes in the tumor location which has alarmed his doctor. It is important to know the exact location, size and appearance of the white spot. There are many reasons for a white appearance on T1 weighted images. MRI scans are very complicated to the untrained eye and an area appearing white on one sequence can appear black in another and until all sequences are seen properly, it is not easy to say with confirmation that there is a bleed. Both T1- and T2-weighted MRIs should be obtained to adequately characterize and stage a bleed.
I request you to kindly send across MRI related documents and reports in the last year till the present. I will go through the technical points in detail before confirming my opinion on whether there is a possible bleed and if present, is it an emergency or not. Bleeds measuring less than 1 cm in a non significant area may not be taken as an emergency and allowed to heal by itself. At the same time a 5 mm bleed in a very important location can cause paralysis. So i is important to know study the current findings in complete details.
MR Spectroscopy is a technique applied to know if a particular area in the brain is showing chemical composition similar to that of a tumor or not. This is done to study suspected recurrence of tumors at operation site or any other area, should a new suspicious tumor like appearance develop.
I understand that the topic we are discussing is not a simple one but it is important to discuss in detail as it refers to health concerns of your husband who has been suddenly having headaches in the last two months.
As you are looking for a clear answer and with limited information available, please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.
Regards,
Dr.Vivek
Request old and current MRI report details
Detailed Answer:
Hi XXXX,
Thanks for writing in to us.
I have read through your query in detail.
Oligodendrogliomas Grade 2 are tumors which are not very aggressive but at the same time require surgery when its growth is causing pressure effects on surrounding structures. I think thats the reason why your husband had it removed 8 years back. In my experience in working with patients with oligodendrogliomas, the reurrence rate is very less and that is something which makes patients comfortable enough to try the wait and watch policy.
Coming to the present MRI dated 11-08-2014, I would like to state that there might have been certain changes in the tumor location which has alarmed his doctor. It is important to know the exact location, size and appearance of the white spot. There are many reasons for a white appearance on T1 weighted images. MRI scans are very complicated to the untrained eye and an area appearing white on one sequence can appear black in another and until all sequences are seen properly, it is not easy to say with confirmation that there is a bleed. Both T1- and T2-weighted MRIs should be obtained to adequately characterize and stage a bleed.
I request you to kindly send across MRI related documents and reports in the last year till the present. I will go through the technical points in detail before confirming my opinion on whether there is a possible bleed and if present, is it an emergency or not. Bleeds measuring less than 1 cm in a non significant area may not be taken as an emergency and allowed to heal by itself. At the same time a 5 mm bleed in a very important location can cause paralysis. So i is important to know study the current findings in complete details.
MR Spectroscopy is a technique applied to know if a particular area in the brain is showing chemical composition similar to that of a tumor or not. This is done to study suspected recurrence of tumors at operation site or any other area, should a new suspicious tumor like appearance develop.
I understand that the topic we are discussing is not a simple one but it is important to discuss in detail as it refers to health concerns of your husband who has been suddenly having headaches in the last two months.
As you are looking for a clear answer and with limited information available, please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.
Regards,
Dr.Vivek
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
