Doctor insights on:
Meningioma En Plaque
Does "calcified dural plaque versus small non-enhancing meningioma" mean it's either plaque or meningioma? I don't understand the use of "versus"
24 yrs smoking.Ct found 11x10 lobular density containing punctate calcification.Posterior lumbar subcutaneous edema.Basilar atelectatic cyst.worry?
Yes . . .: Wow, smoking since 11yo? Bottom line, if screening CT scan finds something abnormal, you need to chat w/ordering physician to discuss your options regarding next step eg how to figure out what's going on. Sometimes the radiologist will suggest repeating a scan in a specific period of time if it's small & indeterminate. But this again is something best discussed w/ordering physician. Best wishes! ...Read more
Idiopathic carotid dissection...No plaque, no disease, horner's. Coumadin/plavix. Fit/very lean 52 y.O. Man-what exercise is okay 2 years out?
Arteriopathy?: Coumadin (warfarin) is indicated for 6 mos. Plavix is not indicated. You should be screened for marfan's, ehlers-danlos type iv, bicuspid aortic valve. The incidence of recurrence is 1%/year for 10 years. If you send me a private request with your email address, i'll email you a review from the new england journal of medicine. Exercises that extend your neck should be avoided. O/w no specific prohibition. ...Read more
Cerebrovascular Duplex Scan reveals bilateral homogeneous plaque present in carotid bulbs. No evidence stenosis/plaque in ICA. Lower stroke risk?
38y f. Brain MRI shows left maxillary polyp, partial empty sella, small chronic ischaemic lesions in subcorticle frontoparietal white matter. Cure?
Nothing to cure: But try to prevent further damage. Maxillary sinus polyp is nothing to worry about unless sinus symptoms, then ENT consult. Partial empty sella cannot be fixed, and nothing to worry about unless abnormal pituitary function - may need to see an endocrinologist. Ischemic lesions may be within normal limits (allowed 1 per decade of life), but need to understand cause(s) and try to prevent more. ...Read more
Brain MRI July2015 8mm calcified meningioma anterior front region, August 2016 a 5mm aneurism right MCA bifurfication. Are these 2 findings related?
No: Both are fairly common. I hope neither becomes troublesome ...Read more
It is: seen in "hardening of the arteries" a disease which is connected with Cholesterol problems. It needs a complete medical/"vascular" evaluation>Start with your PCP (Primary Care provider) Hope this helps! BE WELL TAKE ACTION! Dr Z ...Read more
Mri said aneurysm 8ml and CT angio said 6m. Which is correct? It's carotid berry anurysim suitable for coiling.Told 1% risk bleed & 7% surgey risk?
Explain? Rathe's cleft, epidermoid & arachnoid cysts are in diff., scatrd. foci T2 prolongation affecting the periventricular white matr. bi-lat 4-6mm
A bit more needed: I suggest you review the report either with the doctor who ordered it or a specialist they refer you to or arrange a virtual visit during which you share the whole report The meaning will be easier to understand with the whole report in hand. Cyst is a fluid filled space, Periventricular - around the ventricles. "Arachnoid" "epidermoid" are locations ...Read more
Survival? IVb R base of tongue, 2-3 lymph nodes, tonsil, against epiglottis, around carotid. Male, 51, non hp Tobacco chew prior. 33rad/6-7 chemo
Guarded: Stage IV Ca of base of tongue difficult to manage. These lesions are unresectable and require RT immunochemotherapy for management. RT when completed usually followed by Taxol (paclitaxel) Platinum. When completed, Erbitux- EGF-1 may help. Ive used 1500-2000 mg IV methotrexate over 12 hrs with citrovorum factor rescue , frequently with good responses. If residual lesion in tongue`isotope implant used. ...Read more
S+s of end stage primary brain cancer, (aa iii) r medial temporal lobe, diffuse numerous cells. Growing!/brainstem and posterior temp./basal ganglia?
Ask for more info: Signs and symptoms can vary greatly with any 'end-stage' cancer. Things like if it has spread to other organs, impacting functional status and alertness (sleeping more, in bed most of the time), causing pain/seizures, and so on. His doctors can maybe determine what is most likely. If not involved already ask for hospice or palliative care help as they could also help answer what the s/s might be. ...Read moreSee 1 more doctor answer
What does (1) 436 -Acute, but ill-defined, cerebrovascular disease and (2) 434.10 Cerebral embolism, without mention of cerebral inf codes mean?
Mom is 79 brain CT scan: moderate cerebral volume loss, mild widening of the cortical sulci, mild white matter microvasc. Ischemic disease serious?
Depends: Most likely these are aging changes that have occurred with time. ...Read more
No: Using medications like anti hypercholesterol like Lipitor (atorvastatin) binging bad cholesterol or LDL to below 100 showed in some study that it can prevent progression of atherosclerosis and narrowing in carotid arteries . In minority of patients it shows very slow regression or decrease in size but not significant. If u have symptoms and more than 50% stenosis then surgery is the answer. ...Read moreSee 1 more doctor answer
Periventricular isch chnges, infarcts both cerebral hemispheres incl rt parietal? Vascular event.Blood & vessels ok.Next check pfo, but could it be ms
Possible, but...: Fine to check for pfo, but real question involves potentials for stroke. You could have cadasil, which is a genetic disorder. A spinal tap could assist in diagnosis perhaps. Vasculitis, arteritis, even sjogren's might be considered. Description not necessarily ms, but part of considerations. ...Read more
Would radiation treatment work on a 5.9x4.1x4.2cm left frontal lobe meningioma (benign or malignant)?
A large tumor: A tumor of this size may be causing symptoms and serious consideration of surgical resection should be undertaken by a skilled neurosurgeon. Only if an excellent surgeon has recommended against surgery or the patient has serious medical problems would I advise radiation treatments in a large tumor like this. ...Read moreSee 2 more doctor answers
Ct coronary angiography shows narrowing of ostium of ramus 50-60% and LAD 30-40% , lca 20-30%. Suggest further investigation and treatment?
Next step will be: To correlate those results with your clinics. Are you having any symptoms of chest pain? During exercise? A nuclear stress test vs echocardiogram stress test and possibly a cardiac catheterization next possibilities for further assessment. Depending of your symptoms and the above results, the decision for medical management vs revascularization procedure will be next. Talk to your cardiologist. ...Read more