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What Does My Head MRI And CT Scan Indicate?
Question: Hi there!
I am concerned about brain tumors. I had a head MRI on March 6. They found out in late May, that I had a pseudo tumor.
I alos had a CT scan around May 28th.
I was put on Diamox twice a day and the headaches went away. They just returned about 4 days ago and now im worried it has nothing to do with the pseudo tumor.
My ears feel full sometimes, especially my right ear. Feels tight and i have fluid, on right side mainly. My eyes tend to feel uncomfortable and painful above the eyes and behind. My neck feels pain sometimes and tension. I also get some pain in the back of head as well every ao often.
I saw my GP. He checked ears and throat, and say it may be related to TMJ.
I am a 25 y/o F.
Any advice? Thanks!
I am concerned about brain tumors. I had a head MRI on March 6. They found out in late May, that I had a pseudo tumor.
I alos had a CT scan around May 28th.
I was put on Diamox twice a day and the headaches went away. They just returned about 4 days ago and now im worried it has nothing to do with the pseudo tumor.
My ears feel full sometimes, especially my right ear. Feels tight and i have fluid, on right side mainly. My eyes tend to feel uncomfortable and painful above the eyes and behind. My neck feels pain sometimes and tension. I also get some pain in the back of head as well every ao often.
I saw my GP. He checked ears and throat, and say it may be related to TMJ.
I am a 25 y/o F.
Any advice? Thanks!
Brief Answer:
Pseudotumor cerebri is not TRUE tumor
Detailed Answer:
Good morning. My name is Dr. Dariush Saghafi and I'm a neurologist from the XXXXXXX Ohio region of the world. Greetings to wherever you're at at 4am!
I'd like to address a couple of issues. I'd like to first be sure that you understand what the diagnosis of pseudotumor cerebri (PCT) is and how it is arrived at from a neurologist's perspective.
Pseudotumor cerebri occurs because pressure of fluid within the brain rises tremendously for unknown reasons. Some people believe the "brain is packed" very tightly within in the skull but the evidence for this is weak. We really don't know what causes this phenomenon to occur but they seem to occur mostly in women between 25-50 years of age. There is really no obstruction to fluid flow that can be found though some investigators believe that part of the problem in this disease entity is a failure of fluid to be absorbed and recirculated thus cause a BACKLOG of pressure if you will. The condition is treatable but can recur and will then, have to be RETREATED.
The entity itself is frequently recognized clinically on the based of severe headaches which may have migrainous features (nausea, vomiting, extreme dizziness, difficulty with balance and walking) and are usually debilitating. Also, an entity of "visual obscurations" is often reported by patients where things literally BLANK OUT and this is generally upon bending down at the waist or other postural changes. The loss of vision is temporary but can be very scary.
People at risk are those who are obese (usually very obese: BMI- greater than about 34-35), people who use a lot of vitamin A (Hypervitaminosis A), birth control pills, steroids, and certain medications are known to lead to this condition so check your previous medications for anything that may have been new just before your symptoms started.
There are also data which have shown that being born with NARROW BLOOD VESSELS in the brain's circulation (2 particular veins have been implicated) can lead to the condition later in life. Also, things such as Kidney disease, Lyme disease, other brain infections, and Addision's disease are recognized risk factors.
True diagnosis of the condition should be done with not only imaging (CT or MRI) but also confirmed by a lumbar puncture. This will show extremely elevated opening pressures and usually that's all we need to make the diagnosis. Diamox turns out to be the diuretic of choice to use to reverse the fluid pressures in the head....however, this is only effective in most people for a short period of time before other measures need to be undertaken. If the severe headaches resolved upon taking Diamox and if the initial diagnosis was sound then, I would tend to make your headaches a consequence of the Pseudotumor condition and not TMJ.
I'm not saying that you can't have TMJ...but I would just exercise caution that you don't start traveling down a nonfruitful path of LOOKING to find SOMETHING else that explains headaches which may lead to unnecessary procedures, doctor's visits, medications, yada yada yada if the diagnosis is already in hand. Pseutotumor cerebri is a very sound diagnosis and I'm sure it was made LIGHTLY when given to you....especially if it was done by a neurologist who went through all the proper workup and analysis.
I would respectfully disagree with your primary on the origin of the pains you're referring in the jaw and neck because I typically see those as a consequence of the PCT and that is documented in the literature. TMJ is actually often misdiagnosed in PCT patients since people are thinking about that when patients initially come in for jaw and neck pain. In those patients even though they complain of headaches as well..it seems to be less important than the jaw and throat pain. So the physician diagnoses TMJ and starts them through the papermill of the dentist, the orthodontist, the periodontist....etc., bite blocks, surgeries, more bite blocks, more surgeries.....and the headaches persist, then, the vision starts becoming a problem....so then, to the ophthalmologist....who is usually the one to see the SWOLLEN OPTIC DISCS and makes the right call.
By the way, anybody look in your eyes for this thing? If you've got papilledema (swollen optic discs and nerve heads) then, the diagnosis should be clinched. Even if you don't have the swelling now anymore you have to be careful because remember, you are taking the diamox which can make the discs less swollen even though you still have headaches and even the PCT may still be active.
I know this is all confusing because you've now got at least 2 or 3 doctors trying to convince you of different things. You need to really focus in on your risk factors, your symptoms, and I guess who seems to make the most sense. My money is on the PCT if in fact, the proper workup was performed and either someone saw PAPILLEDEMA in the eyes or did a lumbar puncture which nearly squirted fluid to the ceiling when they took the pressure. If you can tell either of those 2 things are true and that DIAMOX quickly made the headaches VANISH even though they came back....then, I'll stay with PCT as the diagnosis until someone can prove something else....and I would stay away from anybody trying to make you have TMJ because of the pains in the jaw, the mouth, and the neck....those are PCT pains.
If the present information has been helpful (and not confusing) I would absolutely appreciate your written feedback along with a STAR RATING for how I answered this question.
If you have no further questions or comments to place could you also do me the favor of CLOSING THE QUERY which will alert the network to process, archive, and credit this question appropriately for future reference?
I'm happy to answer all future questions personally through the following website:
http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=68474
This query required 47 minutes of physician specific review, research, and final draft documentation for envoy.
Pseudotumor cerebri is not TRUE tumor
Detailed Answer:
Good morning. My name is Dr. Dariush Saghafi and I'm a neurologist from the XXXXXXX Ohio region of the world. Greetings to wherever you're at at 4am!
I'd like to address a couple of issues. I'd like to first be sure that you understand what the diagnosis of pseudotumor cerebri (PCT) is and how it is arrived at from a neurologist's perspective.
Pseudotumor cerebri occurs because pressure of fluid within the brain rises tremendously for unknown reasons. Some people believe the "brain is packed" very tightly within in the skull but the evidence for this is weak. We really don't know what causes this phenomenon to occur but they seem to occur mostly in women between 25-50 years of age. There is really no obstruction to fluid flow that can be found though some investigators believe that part of the problem in this disease entity is a failure of fluid to be absorbed and recirculated thus cause a BACKLOG of pressure if you will. The condition is treatable but can recur and will then, have to be RETREATED.
The entity itself is frequently recognized clinically on the based of severe headaches which may have migrainous features (nausea, vomiting, extreme dizziness, difficulty with balance and walking) and are usually debilitating. Also, an entity of "visual obscurations" is often reported by patients where things literally BLANK OUT and this is generally upon bending down at the waist or other postural changes. The loss of vision is temporary but can be very scary.
People at risk are those who are obese (usually very obese: BMI- greater than about 34-35), people who use a lot of vitamin A (Hypervitaminosis A), birth control pills, steroids, and certain medications are known to lead to this condition so check your previous medications for anything that may have been new just before your symptoms started.
There are also data which have shown that being born with NARROW BLOOD VESSELS in the brain's circulation (2 particular veins have been implicated) can lead to the condition later in life. Also, things such as Kidney disease, Lyme disease, other brain infections, and Addision's disease are recognized risk factors.
True diagnosis of the condition should be done with not only imaging (CT or MRI) but also confirmed by a lumbar puncture. This will show extremely elevated opening pressures and usually that's all we need to make the diagnosis. Diamox turns out to be the diuretic of choice to use to reverse the fluid pressures in the head....however, this is only effective in most people for a short period of time before other measures need to be undertaken. If the severe headaches resolved upon taking Diamox and if the initial diagnosis was sound then, I would tend to make your headaches a consequence of the Pseudotumor condition and not TMJ.
I'm not saying that you can't have TMJ...but I would just exercise caution that you don't start traveling down a nonfruitful path of LOOKING to find SOMETHING else that explains headaches which may lead to unnecessary procedures, doctor's visits, medications, yada yada yada if the diagnosis is already in hand. Pseutotumor cerebri is a very sound diagnosis and I'm sure it was made LIGHTLY when given to you....especially if it was done by a neurologist who went through all the proper workup and analysis.
I would respectfully disagree with your primary on the origin of the pains you're referring in the jaw and neck because I typically see those as a consequence of the PCT and that is documented in the literature. TMJ is actually often misdiagnosed in PCT patients since people are thinking about that when patients initially come in for jaw and neck pain. In those patients even though they complain of headaches as well..it seems to be less important than the jaw and throat pain. So the physician diagnoses TMJ and starts them through the papermill of the dentist, the orthodontist, the periodontist....etc., bite blocks, surgeries, more bite blocks, more surgeries.....and the headaches persist, then, the vision starts becoming a problem....so then, to the ophthalmologist....who is usually the one to see the SWOLLEN OPTIC DISCS and makes the right call.
By the way, anybody look in your eyes for this thing? If you've got papilledema (swollen optic discs and nerve heads) then, the diagnosis should be clinched. Even if you don't have the swelling now anymore you have to be careful because remember, you are taking the diamox which can make the discs less swollen even though you still have headaches and even the PCT may still be active.
I know this is all confusing because you've now got at least 2 or 3 doctors trying to convince you of different things. You need to really focus in on your risk factors, your symptoms, and I guess who seems to make the most sense. My money is on the PCT if in fact, the proper workup was performed and either someone saw PAPILLEDEMA in the eyes or did a lumbar puncture which nearly squirted fluid to the ceiling when they took the pressure. If you can tell either of those 2 things are true and that DIAMOX quickly made the headaches VANISH even though they came back....then, I'll stay with PCT as the diagnosis until someone can prove something else....and I would stay away from anybody trying to make you have TMJ because of the pains in the jaw, the mouth, and the neck....those are PCT pains.
If the present information has been helpful (and not confusing) I would absolutely appreciate your written feedback along with a STAR RATING for how I answered this question.
If you have no further questions or comments to place could you also do me the favor of CLOSING THE QUERY which will alert the network to process, archive, and credit this question appropriately for future reference?
I'm happy to answer all future questions personally through the following website:
http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=68474
This query required 47 minutes of physician specific review, research, and final draft documentation for envoy.
Above answer was peer-reviewed by :
Dr. Prasad
I guess im trying to figure out why it went away for so long and then came back. I have been taking Diamox for twice a day and everything had gone away for about 4.5 months. When it started roughly 4-5 days ago, I am now on Diamox 3 times a day, but it doesn't seem to make any difference..my pressure was 35 at the time of diagnoses and my neuro opthamologist said it was going down slightly, durin each visit (I had two visits and the last one was about 4-5 weeks ago), and that is why im cofused about the pressure now. g
Brief Answer:
If you figure it out then, you'll be a STAR!
Detailed Answer:
Thanks for the question again on the PCT. Honestly, if you can actually figure out exactly WHY your PCT is not responding to the diamox the way was in the beginning then, you'll be able to make medical news. If you'll look up top I did mention that with PCT (as with many medical conditions that are chronic) treatments which work now may not work later and there is nothing more we can do or say except to try another treatment, raise the dose of the drug, perhaps try and figure out if interactions between drugs could be occurring (sometimes that happens), etc.
But it's not unusual for PCT patient to experience an improvement and sometimes a lot of improvement followed by a "back to square 1" type of scenrio. I know that's not a great reason.....but it's all our knowledge allows us to say at this time. There are other medications that could be tried as well as surgical procedures. But for those types of procedures you'll probably want to be absolutely sure first that you do not respond to any other medical therapy.
Sometimes, I've had it where I'll take my patient off the Diamox because it's not working and try them on some other agent to promote diuresis and then, after several months revert back to the Diamox. Sometimes you can "trick" the body into responding again to a drug that it stopped responding to for a while.
So bottom line is the diamox has a limit of usefulness beyond which the body simply finds a way to overcome its action. Does that make sense?
Do you suffer any other risk factors that I had mentioned? Obesity, Use of vitamin A, Retinol, other medications that cause PCT, kidney dysfunction, new medications that could be interfering with the diamox. Because if so, then, controlling any of those additional factors may bring more response back to the diamox as well. I forgot to mention that sleep apnea can be a complicating factor for PCT. Do you have that? Have you been screened for it?
If the present information has been helpful (and not confusing) I would absolutely appreciate your written feedback along with a STAR RATING for how I answered this question.
If you have no further questions or comments to place could you also do me the favor of CLOSING THE QUERY which will alert the network to process, archive, and credit this question appropriately for future reference?
I'm happy to answer all future questions personally through the following website:
http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=68474
This query required 15 minutes of physician specific review, research, and final draft documentation for envoy.
If you figure it out then, you'll be a STAR!
Detailed Answer:
Thanks for the question again on the PCT. Honestly, if you can actually figure out exactly WHY your PCT is not responding to the diamox the way was in the beginning then, you'll be able to make medical news. If you'll look up top I did mention that with PCT (as with many medical conditions that are chronic) treatments which work now may not work later and there is nothing more we can do or say except to try another treatment, raise the dose of the drug, perhaps try and figure out if interactions between drugs could be occurring (sometimes that happens), etc.
But it's not unusual for PCT patient to experience an improvement and sometimes a lot of improvement followed by a "back to square 1" type of scenrio. I know that's not a great reason.....but it's all our knowledge allows us to say at this time. There are other medications that could be tried as well as surgical procedures. But for those types of procedures you'll probably want to be absolutely sure first that you do not respond to any other medical therapy.
Sometimes, I've had it where I'll take my patient off the Diamox because it's not working and try them on some other agent to promote diuresis and then, after several months revert back to the Diamox. Sometimes you can "trick" the body into responding again to a drug that it stopped responding to for a while.
So bottom line is the diamox has a limit of usefulness beyond which the body simply finds a way to overcome its action. Does that make sense?
Do you suffer any other risk factors that I had mentioned? Obesity, Use of vitamin A, Retinol, other medications that cause PCT, kidney dysfunction, new medications that could be interfering with the diamox. Because if so, then, controlling any of those additional factors may bring more response back to the diamox as well. I forgot to mention that sleep apnea can be a complicating factor for PCT. Do you have that? Have you been screened for it?
If the present information has been helpful (and not confusing) I would absolutely appreciate your written feedback along with a STAR RATING for how I answered this question.
If you have no further questions or comments to place could you also do me the favor of CLOSING THE QUERY which will alert the network to process, archive, and credit this question appropriately for future reference?
I'm happy to answer all future questions personally through the following website:
http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=68474
This query required 15 minutes of physician specific review, research, and final draft documentation for envoy.
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
Thank you! Yes, as of right now, im about 100 lbs overweight and trying to lose the weight now. Also, I had a sleep test done and they said it was all good.
Brief Answer:
That's Terrific you're gonna get the weight off
Detailed Answer:
Atta girl!
You get some of that weight off and you may make that diamox start working again. And that's good news that you're not suffering from sleep apnea......you're too young to have those issues as well.
Good luck....
If the present information has been helpful; I would absolutely be very thankful for your written feedback and a STAR RATING for how I answered this question.
If you have no further questions or comments to place could you also do me the favor of CLOSING THE QUERY which will alert the network to process, archive, and credit this question appropriately for future reference?
I'm happy to answer all future questions personally through the following website:
http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=68474
This query required 8 minutes of physician specific review, research, and final draft documentation for envoy.
That's Terrific you're gonna get the weight off
Detailed Answer:
Atta girl!
You get some of that weight off and you may make that diamox start working again. And that's good news that you're not suffering from sleep apnea......you're too young to have those issues as well.
Good luck....
If the present information has been helpful; I would absolutely be very thankful for your written feedback and a STAR RATING for how I answered this question.
If you have no further questions or comments to place could you also do me the favor of CLOSING THE QUERY which will alert the network to process, archive, and credit this question appropriately for future reference?
I'm happy to answer all future questions personally through the following website:
http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=68474
This query required 8 minutes of physician specific review, research, and final draft documentation for envoy.
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
Answered by
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