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What Causes Cervical Lordosis With Mild Prominence Of The Cerebellar Folia?
Posted on
Sat, 17 Dec 2016
Medically reviewed by
Ask A Doctor - 24x7 Medical Review Team
Sat, 17 Dec 2016
Answered on
Mon, 9 Jan 2017
Last reviewed on
Question : Hello,
My daughter was a pedestrian in an MVA accident. Brain scans note cervical lordosis and prominence of the cerebellar folia. I have not gained access to the MRI's unfortunately. However, recently I received another report which states: "there is a left parietal/basal ganglia right cerebellar dysfunction.
Could you please tell me how this might manifest itself, and what exactly this means? The accident occurred over four years ago and her leg tremors/balance are getting worse. She now requires a cane and brace to walk. As well, she has full body myoclonus jerks - these appear random and I am told do not have any relationship to spasticity. She falls frequently, and there are memory and cognitive issues. She attempted to return to college but was unable to understand/comprehend simple text.
Her sleep study, performed by another neurologists states that she has 139 NRem arousals for a six hour time period. Her N3 sleep was a total of 9 minutes. The medical equipment had to be adjusted and replaced three times throughout the study. She was referred to a movement disorder clinic. Her PLM was also elevated and it took her quite a while to fall asleep.
Thank you so much for your time.
Best Regards XXXXXXX
My daughter was a pedestrian in an MVA accident. Brain scans note cervical lordosis and prominence of the cerebellar folia. I have not gained access to the MRI's unfortunately. However, recently I received another report which states: "there is a left parietal/basal ganglia right cerebellar dysfunction.
Could you please tell me how this might manifest itself, and what exactly this means? The accident occurred over four years ago and her leg tremors/balance are getting worse. She now requires a cane and brace to walk. As well, she has full body myoclonus jerks - these appear random and I am told do not have any relationship to spasticity. She falls frequently, and there are memory and cognitive issues. She attempted to return to college but was unable to understand/comprehend simple text.
Her sleep study, performed by another neurologists states that she has 139 NRem arousals for a six hour time period. Her N3 sleep was a total of 9 minutes. The medical equipment had to be adjusted and replaced three times throughout the study. She was referred to a movement disorder clinic. Her PLM was also elevated and it took her quite a while to fall asleep.
Thank you so much for your time.
Best Regards XXXXXXX
Brief Answer:
Ahhh.....now, there is some CLINICAL information that you provide; helpful
Detailed Answer:
So, now I see you have provided additional information about your daughter's condition which can be much better correlated to the phases you mention.
Specifically, if your daughter's having increasing tremors in the legs and issues of balance then, these symptoms can be directly related to damage to the cerebellum or cerebellar atrophy which is what is implied in the report that states "increased prominence of the folia." Perhaps, there is a worse side to the tremors or myoclonic jerks which is why someone may have thought that the RIGHT cerebellar function was mainly affected but in reality if both legs are tremoring, jerking, or she's losing balance on both sides of the body then, a more logical explanation would be that the entire cerebellum is involved.
Memory and cognitive issues are not necessarily explained by either the radiographic findings nor the clinical impression the left parietal/basal ganglia regions are involved but that is where a neuropsychologist should enter into the picture to assess her especially if she cannot function in college because of what's happening.
Problems with insomnia and sleeplessness is a common consequence as well as increased PERIODIC LEG MOVEMENTS (PLM's) are seen in TBI victims as well.
All the best.
Ahhh.....now, there is some CLINICAL information that you provide; helpful
Detailed Answer:
So, now I see you have provided additional information about your daughter's condition which can be much better correlated to the phases you mention.
Specifically, if your daughter's having increasing tremors in the legs and issues of balance then, these symptoms can be directly related to damage to the cerebellum or cerebellar atrophy which is what is implied in the report that states "increased prominence of the folia." Perhaps, there is a worse side to the tremors or myoclonic jerks which is why someone may have thought that the RIGHT cerebellar function was mainly affected but in reality if both legs are tremoring, jerking, or she's losing balance on both sides of the body then, a more logical explanation would be that the entire cerebellum is involved.
Memory and cognitive issues are not necessarily explained by either the radiographic findings nor the clinical impression the left parietal/basal ganglia regions are involved but that is where a neuropsychologist should enter into the picture to assess her especially if she cannot function in college because of what's happening.
Problems with insomnia and sleeplessness is a common consequence as well as increased PERIODIC LEG MOVEMENTS (PLM's) are seen in TBI victims as well.
All the best.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hello Dr. Saghafi,
Thank you so much for your prompt reply! For me, atrophy could mean a worsening condition as time progresses. So is it possible that the prominence of the cerebellar folio, could in fact NOT have been immediately noticeable on a CT or MRI. However as time progresses, the prominence of the cerebellar folio becomes more pronounced and therefore noticeable?
[She also hits her right arm erratically on tables sometimes]
Could the cervical lordosis in any way be connected to the dextrocurvature of the spine, and loss of disc height in the L5, which I have just found out about? She cannot sleep for any time in the supine position.
I will try immediately to find a neuropsychologist up here in Canada.
Best regards
and thank you so much XXXXXXX
Thank you so much for your prompt reply! For me, atrophy could mean a worsening condition as time progresses. So is it possible that the prominence of the cerebellar folio, could in fact NOT have been immediately noticeable on a CT or MRI. However as time progresses, the prominence of the cerebellar folio becomes more pronounced and therefore noticeable?
[She also hits her right arm erratically on tables sometimes]
Could the cervical lordosis in any way be connected to the dextrocurvature of the spine, and loss of disc height in the L5, which I have just found out about? She cannot sleep for any time in the supine position.
I will try immediately to find a neuropsychologist up here in Canada.
Best regards
and thank you so much XXXXXXX
Brief Answer:
I think you're saying the same thing in the NEGATIVE format
Detailed Answer:
LOL.....sorry, that I'm not clarifying this for you but it appears that you're saying the same thing about the cerebellar folia and implied atrophy that I said in my response but you're now using a negative of what was originally. Hopefully this should clear everything up from that perspective:
When a patient suffers a blow to the head it is often the case that imaging studies performed very close in time to the incident DO NOT SHOW any major architectural changes or "damage" if you will to parts exposed to the concussive force or blow. However, over time which can be weeks, months, or years into the future.....it is possible to SEE actual structural changes in parts of the brain such as ATROPHY, SHRINKAGE, DAMAGE resulting in phenomenon like ENCEPHALOMALACIA (deterioration of brain tissue resulting in scarring and shrinkage), HEMOSIDERIN DEPOSITS (remnants of blood in an area which may have suffered bleeding of some sort), HYDROCEPHALUS (water on the brain).
In your daughter's case it would appear that there is an INCREASE in CEREBELLAR FOLIA prominence. From what you're stating previous scans did not show this feature but recent scans do.....so YES, I believe the most reasonable interpretation of the scans in your daughter's case is that damage did occur to the cerebellum due to the accident as a pedestrian. Initial scans did not show any abnormalities but now there is ATROPHY of the CEREBELLAR FOLIA and this is what's becoming more noticeable as time goes on which is then, consistent with the clinical symptoms she is demonstrating of tremoring, loss of balance, and quite possibly myoclonic jerks....though other things could also be looked for as contributing.
Hope that clears up the issue for you sufficiently.
As far as "cervical lordosis" is concerned...it appears that you are using that term thinking that it is pathological or abnormal. It is not. the word LORDOSIS simply refers to a CURVATURE of the backbone. All of us have 4 LORDOSES in our spines. 2 of them point in the same direction which would be the neck and lower back (lumbar region) while 2 of them in the Thorax and coccygeal regions (tailbone) point in the same but opposite directions. You can look up Spinal column LORDOSES to see what this looks like in the normal condition. Therefore, there is really nothing to connect the term CERVICAL LORDOSIS to DEXTROCURVATURE of the spine. My terminology I think would've been more likely to say that your daughter possesses a DEXTROSCOLIOSIS of the cervical spine which means that there is an abnormal deviation of the NORMAL CERVICAL LORDOSIS (curvature) which opens to the right (DEXTRO-). The dextrocurvature in the neck is unlikely to have any relationship to the loss of height in L5 which is in the lumbar spine....too far away. It doesn't XXXXXXX me that she would have trouble sleeping with the neck scoliosis.
Please close this query with a high 5 star rating and some positive feedback commentary if I have helped you understand your concerns better than you had before. All the best to you and your daughter.
This query has resulted in 37 minutes of professional time, research, and assimilation times for return envoy to the patient.
I think you're saying the same thing in the NEGATIVE format
Detailed Answer:
LOL.....sorry, that I'm not clarifying this for you but it appears that you're saying the same thing about the cerebellar folia and implied atrophy that I said in my response but you're now using a negative of what was originally. Hopefully this should clear everything up from that perspective:
When a patient suffers a blow to the head it is often the case that imaging studies performed very close in time to the incident DO NOT SHOW any major architectural changes or "damage" if you will to parts exposed to the concussive force or blow. However, over time which can be weeks, months, or years into the future.....it is possible to SEE actual structural changes in parts of the brain such as ATROPHY, SHRINKAGE, DAMAGE resulting in phenomenon like ENCEPHALOMALACIA (deterioration of brain tissue resulting in scarring and shrinkage), HEMOSIDERIN DEPOSITS (remnants of blood in an area which may have suffered bleeding of some sort), HYDROCEPHALUS (water on the brain).
In your daughter's case it would appear that there is an INCREASE in CEREBELLAR FOLIA prominence. From what you're stating previous scans did not show this feature but recent scans do.....so YES, I believe the most reasonable interpretation of the scans in your daughter's case is that damage did occur to the cerebellum due to the accident as a pedestrian. Initial scans did not show any abnormalities but now there is ATROPHY of the CEREBELLAR FOLIA and this is what's becoming more noticeable as time goes on which is then, consistent with the clinical symptoms she is demonstrating of tremoring, loss of balance, and quite possibly myoclonic jerks....though other things could also be looked for as contributing.
Hope that clears up the issue for you sufficiently.
As far as "cervical lordosis" is concerned...it appears that you are using that term thinking that it is pathological or abnormal. It is not. the word LORDOSIS simply refers to a CURVATURE of the backbone. All of us have 4 LORDOSES in our spines. 2 of them point in the same direction which would be the neck and lower back (lumbar region) while 2 of them in the Thorax and coccygeal regions (tailbone) point in the same but opposite directions. You can look up Spinal column LORDOSES to see what this looks like in the normal condition. Therefore, there is really nothing to connect the term CERVICAL LORDOSIS to DEXTROCURVATURE of the spine. My terminology I think would've been more likely to say that your daughter possesses a DEXTROSCOLIOSIS of the cervical spine which means that there is an abnormal deviation of the NORMAL CERVICAL LORDOSIS (curvature) which opens to the right (DEXTRO-). The dextrocurvature in the neck is unlikely to have any relationship to the loss of height in L5 which is in the lumbar spine....too far away. It doesn't XXXXXXX me that she would have trouble sleeping with the neck scoliosis.
Please close this query with a high 5 star rating and some positive feedback commentary if I have helped you understand your concerns better than you had before. All the best to you and your daughter.
This query has resulted in 37 minutes of professional time, research, and assimilation times for return envoy to the patient.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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