Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Suggest Treatment For Recurring Vomiting
Question: Help I am an attorney and our client has been accused of Munchausen by Proxy because her child had a feeding tube due to recurrent vomiting and an inability to digest regular foods. Symptoms continued from tie child was a baby until 5 years old. However, when we read the reports there is a CT scan that was done when the child was 5 and a cisterna magna vs. retrocerebellar cyst was found. I read that such a cyst can cause vomiting. Any advice or help would be appreciated.
Brief Answer:
Retrocerebellar cysts
Detailed Answer:
Good afternoon. My name is Dr. Saghafi and I am a neurologist. I am interested in answering your question about retrocerebellar vs. magna cisterna cysts. Do you you have either some imaging studies or their reports? Did they grade the arachnoid cyst in terms of its Galassi score?
As you probably know most arachnoid cysts are inconsequential and the vast majority of people live and die without knowing of their existence. So a lot rides on the size, location, and whether or not there is what we call "mass" effect meaning that it causes or provokes pressure against structures within the head if we are going to ascribe a relationship between the cyst and the symptoms.
Nausea and vomiting are certainly potential symptoms of arachnoid cysts located virtually anywhere inside the cranial vault. Do we have a confirmation on whether in fact this the CT image was clearly defined as a cyst vs. a magna cisterna? At the end of the day both can do cause vomiting but for informational purposes it would be nice for me to know which entity we have on the table.
If the cyst were ever drained or a shunt placed due to hydrocephalus did the vomiting improve?
If any of the information I've asked or provided has been useful to further your understanding or give you ideas as to which direction to turn next and you'd like to CLOSE THIS QUERY then, could you do me a favor and leave some brief feedback with a STAR RATING for the quality of the response?
Alternatively, we could continue this conversation and you may upload information if available such as lab tests, etc. and I would be happy to review them. I would especially love to see any CT or MRI's of the brain then, and now.
Please feel free to contact me at any time to ask more questions about this or any other topic you would like by using the following link:
http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=68474
This query required 81 minutes of physician specific time to review, research, and compile the final draft for envoy.
Retrocerebellar cysts
Detailed Answer:
Good afternoon. My name is Dr. Saghafi and I am a neurologist. I am interested in answering your question about retrocerebellar vs. magna cisterna cysts. Do you you have either some imaging studies or their reports? Did they grade the arachnoid cyst in terms of its Galassi score?
As you probably know most arachnoid cysts are inconsequential and the vast majority of people live and die without knowing of their existence. So a lot rides on the size, location, and whether or not there is what we call "mass" effect meaning that it causes or provokes pressure against structures within the head if we are going to ascribe a relationship between the cyst and the symptoms.
Nausea and vomiting are certainly potential symptoms of arachnoid cysts located virtually anywhere inside the cranial vault. Do we have a confirmation on whether in fact this the CT image was clearly defined as a cyst vs. a magna cisterna? At the end of the day both can do cause vomiting but for informational purposes it would be nice for me to know which entity we have on the table.
If the cyst were ever drained or a shunt placed due to hydrocephalus did the vomiting improve?
If any of the information I've asked or provided has been useful to further your understanding or give you ideas as to which direction to turn next and you'd like to CLOSE THIS QUERY then, could you do me a favor and leave some brief feedback with a STAR RATING for the quality of the response?
Alternatively, we could continue this conversation and you may upload information if available such as lab tests, etc. and I would be happy to review them. I would especially love to see any CT or MRI's of the brain then, and now.
Please feel free to contact me at any time to ask more questions about this or any other topic you would like by using the following link:
http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=68474
This query required 81 minutes of physician specific time to review, research, and compile the final draft for envoy.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
I will send you the cat scans. If this is the cause of the child's vomiting it could explain a lot about the child's symptoms. Would a ultrasound also show such a cyst?
Brief Answer:
Depends upon the other symptoms you refer
Detailed Answer:
But the short answer is "For Sure...." However, I don't understand how the mother can possibly be accused for Munchausen. A feeding tube in a pediatric patient is placed by a physician and if somebody ordered the CT scan then, the same person dropping the tube would've known about the cyst. Was this cyst never drained or shunted? Is this child hydrocephalic (enlarged head due to excess fluid in the brain?" Or are they saying that the tube was put down by the mother? If so, Bravo Mamma...could use her on a couple of peds floors that I know for some backup assistance....not easy to do in a kid.....
If any of the information I've asked or provided has been useful to further your understanding or give you ideas as to which direction to turn next and you'd like to CLOSE THIS QUERY then, could you do me a favor and leave some brief feedback with a STAR RATING for the quality of the response?
Alternatively, we could continue this conversation and you may upload information if available such as lab tests, etc. and I would be happy to review them. I would especially love to see any CT or MRI's of the brain then, and now.
Please feel free to contact me at any time to ask more questions about this or any other topic you would like by using the following link:
http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=68474
This query required 5 minutes of physician specific time to review, research, and compile the final draft for envoy.
Depends upon the other symptoms you refer
Detailed Answer:
But the short answer is "For Sure...." However, I don't understand how the mother can possibly be accused for Munchausen. A feeding tube in a pediatric patient is placed by a physician and if somebody ordered the CT scan then, the same person dropping the tube would've known about the cyst. Was this cyst never drained or shunted? Is this child hydrocephalic (enlarged head due to excess fluid in the brain?" Or are they saying that the tube was put down by the mother? If so, Bravo Mamma...could use her on a couple of peds floors that I know for some backup assistance....not easy to do in a kid.....
If any of the information I've asked or provided has been useful to further your understanding or give you ideas as to which direction to turn next and you'd like to CLOSE THIS QUERY then, could you do me a favor and leave some brief feedback with a STAR RATING for the quality of the response?
Alternatively, we could continue this conversation and you may upload information if available such as lab tests, etc. and I would be happy to review them. I would especially love to see any CT or MRI's of the brain then, and now.
Please feel free to contact me at any time to ask more questions about this or any other topic you would like by using the following link:
http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=68474
This query required 5 minutes of physician specific time to review, research, and compile the final draft for envoy.
Above answer was peer-reviewed by :
Dr. Yogesh D
The feeding tube was inserted by CHOP. Thereafter, the child has symptoms od dysautonomia. This was observed by a doctor. All of her treatment was done at Children's Hospital of XXXXXXX The mother was accused of Munchausen when she refused to allow her child who was 6 years old to remain overnight in a hospital for an indefinite period so that she could be treated for Amplified Muscuskeletal Pain Syndrome with a Dr. named Dr. XXXXXXX at CHOP. When she determined that this treatment was not satisfactory to her, he called in the referral.
I will get you the CT scans as soon as possible. Where do you practice. XXXX
I will get you the CT scans as soon as possible. Where do you practice. XXXX
Brief Answer:
Unable to open files of CT scans
Detailed Answer:
Good morning. Thank you for taking the time to send me the files for the CT scans. Is it not possible to simply upload them as .jpg images to this webpage along with the consult query? I am entirely unable to open the files as they've been sent.
And so I understand that the feeding tube was placed by someone at Children's Hospital of XXXXXXX (CHOP?) and that the doctor witnessed them dropping the tube, correct? The mother was accused of MUNCHAUSEN Syndrome due to the mother going against medical advice and refusing to let the child stay in the hospital overnight to be treated for Amplified Musculoskeletal Pain Sydrome. Dr. XXXXXXX is the child's current pediatrician.
I practice in XXXXXXX OH in my own private practice and I am also the Director of the Headache Clinic through the Neurology Dept at the XXXXXXX Stokes VA Medical Center in XXXXXXX OH.
Unable to open files of CT scans
Detailed Answer:
Good morning. Thank you for taking the time to send me the files for the CT scans. Is it not possible to simply upload them as .jpg images to this webpage along with the consult query? I am entirely unable to open the files as they've been sent.
And so I understand that the feeding tube was placed by someone at Children's Hospital of XXXXXXX (CHOP?) and that the doctor witnessed them dropping the tube, correct? The mother was accused of MUNCHAUSEN Syndrome due to the mother going against medical advice and refusing to let the child stay in the hospital overnight to be treated for Amplified Musculoskeletal Pain Sydrome. Dr. XXXXXXX is the child's current pediatrician.
I practice in XXXXXXX OH in my own private practice and I am also the Director of the Headache Clinic through the Neurology Dept at the XXXXXXX Stokes VA Medical Center in XXXXXXX OH.
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
