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Neuro Doctor
Neuro Doctor, Neurologist (MD)
Category: Neurology
Satisfied Customers: 4765
Experience:  American Board Certified Neurologist, Internal Medicine
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I have a question for a neurologist: my son was diagnosed

Customer Question

i have a question for a neurologist:
my son was diagnosed with a 2mm cyst on the left side of his brain when he was about 8yrs of age. he is currently 19yrs of age. the reason i took him to see a neurologist back then was because he has been experiencing a lot of nervous tics, complaining of pain in his head whenever i would even try to brush his hair as an infant. we were involved in a couple of accidents when he was an infant as well. one accident in potential he had a bruise on his head. but no test were run on him at that time. so don't know what caused that cyst and if it is still there. my main concern right now is that my son have been having a lot of mood swings, quick temper, and just hard to get alone with most of the time and he is just upset for no good reason at all i start noticing his temper when he was in the 7th or 8th grade. but his moodiness has really gone to another level. i just don't know if he needs to see a neurologist to have another mri done to see if that cyst is still there or not? could it be maybe his b vitamin levels are low or something-else? thank you.
Submitted: 3 months ago.
Category: Neurology
Expert:  Dr. David replied 3 months ago.

Hello, this is Dr. David. I am reviewing your question now and will be with you momentarily.

Expert:  Dr. David replied 3 months ago.

I am sorry about your son

his symptoms you mentioned don't sound typical from being caused by a brain cyst, even if the cyst was enlarging.

you can have him see a primary care doctor or even a neurologist. that is fine

but I bet if he gets a scan, that cyst would be stable.

his moodiness can be from many different causes. should see a primary care doctor and get a full physical and medical workup including blood testing and thyroid hormone tests.

the temper could be behavioral or metabolic

he may benefit from seeing a psychotherapist for counseling or group therapy

he may benefit from releasing some stress and anxiety

he may benefit from regular exercise.

usually low vitamin B levels would not cause these symptoms.

Customer: replied 3 months ago.
thanks for the response dr. mark.
What do you mean by the cyst could be stable if it is still there? does that mean it is not dangerous and could it have turned into a tumor. i was reading that they hypothalamus part of the brain controls emotions, behavior, etc. is this part of the brain on the left side of the brain? the 2mm cyst was on the left side of brain.what do you mean about temper could be metabolic?my son is very active for the most part. athlete in college. do you think mri should be repeated to see if cyst still there?
Customer: replied 3 months ago.
sorry; meant to say dr. david.
Customer: replied 3 months ago.
are you still there?
Expert:  Dr. David replied 3 months ago.

yes, most likely the cyst if it is still there is stable and hasn't changed.

yes, it is most likely not dangerous

chances for brain tumor are super super super small.

many different parts of the brain control emotions and behavior

that is good he is athletic

I don't think he needs an MRI scan at this point just because of moodiness and bad temper

but he should see a doctor to get an exam and evaluation

let me know if you have other questions.

if done for now, please leave positive rating of 3-5 stars so I can get credit for helping you today

we only get credit for helping clients after positive feedback

you can always reach me directly with "a question for Dr. David" in the medicine or oncology categories if you have other questions

here is my website if you need to reach me:

http://www.justanswer.com/medical/expert-dr-david/

Thanks for using JustAnswers.com

Customer: replied 3 months ago.
hello dr. david, thanks for the response.are you a neurologist specialist? i see you listed as oncology, radiology, etc? thank you.
Expert:  Dr. David replied 3 months ago.

I am a board certified oncologist

who deals with neurology issues all the time.

Expert:  Dr. David replied 3 months ago.

I went to a medical school in the USA and was trained in residency program in NY City.

Customer: replied 3 months ago.
dr. david, will you please opt out? i need a neurologist specialist to please answer this question.
Customer: replied 3 months ago.
Hello Dr. David,
Will you please opt out? I really need to hear from a board certified Neurologist as I originally requested. Thank you.
Expert:  Neuro Doctor replied 3 months ago.

Hi, I am an American Board Certified Neurologist with vast experience in diagnosing & treating all types of neurological & other medical conditions including the concerns of “worsening moodiness, temper and personality change in your son” you have mentioned here and I am very glad to help you with your health concerns.

I have tried to answer your questions/concerns one by one below here;

1) so don't know what caused that cyst and if it is still there.

There are different types of cysts in the brain, and even prior head traumas too can cause cysts in the brain which are called post traumatic cysts. He did suffer from some head injuries when he was infant so trauma induced cyst is a possibility too. These type of cysts generally are not expected to grow, they generally resolve after some time

Another type of cyst is called is Arachnoid cyst. These are considered as congenital cysts means people are born with them. These type of cysts in general remain of the same size throughout life but rarely they can increase in size and start causing symptoms.

There are many other types of cysts in the brain and called as Pineal cysts, Choroidal fissure cysts etc.

As you see there are varieties of cysts related to the brain. And some of them can grow further, some of them do not grow. Those which can grow further can cause pressure effect on the area of the brain where they are located and cause neurological symptoms. If a cyst is causing pressure on certain parts of the brain like temporal lobe, or frontal lobe, or areas like hypothalamus etc it can cause changes in the mood, emotions, personality and behaviors etc

2) i just don't know if he needs to see a neurologist to have another mri done to see if that cyst is still there or not?

Yes it is good idea to see a neurologist now. As pointed above certain cysts can grow further and can cause the type of symptoms he is having, so seeing a neurologist is recommended now. And he also needs an MRI scan of the brain to see what is the exact status of the cyst - whether it has grown further or not, and also to look for any other new health conditions affecting the brain that may be causing his manifestations.

3) could it be maybe his b vitamin levels are low or something-else?

At this moment there are many different conditions that can cause his manifestations, so he needs a thorough further evaluations which should include a neurological evaluation and brain MRI scan as mentioned above, and also we need to explore other possibilities for example vitamin deficiencies too can cause his manifestations, for example vitamin b12, or folate, niacin etc vitamin deficiencies can cause these type of manifestations he is having. I am not sure how far he has already been investigated, even thyroid diseases too can cause his manifestations, so if not already checked then he also needs testing for his thyroid function too, along with blood vitamin levels.

To summarize once again, yes his symptoms can be related to the cyst, he needs a neurological evaluation, he needs an MRI scan of the brain to see whether the cyst or any other neurological/brain conditions causing his new manifestations, and also he needs additional evaluation to rule out vitamin deficiencies, thyroid issues etc, and then treated appropriately depending upon the test results.

Please let me know if you have any further questions, and please click a positive rating (preferably 5 Star/Excellent) to credit for the time & effort put by me in answering your health question, and this is the only way I will be credited for my service to you. If you have follow-up or additional questions you can ask them after the rating too.

Best regards,

Neuro Doctor

Customer: replied 3 months ago.
Hello neuro doctor, what is your name?Thanks for the information that you provided. I will take your advice and take my son to see a neurologist so hopefully they will be able to order an Mri and check his vit b levels, folate, and niacin as well. he just had blood work done this past July for cbc panel, cmp, tsh, fsh, lh and std. everything came back normal except it showed his calcium being little elevated at 10.5. he is 19 yrs of age and i spoke with my endocrinoligist and she stated that since his albumin was 5.0 and calcium 10.5, she mentioned that you have to subtract and his actual calcium level is 9.7. so hopefully that is correct. not sure why that primary dr didn't do the calculations. i hope this calculation is correct, because if not, that could be due to hyperparathyroidism. i may ask to have his PTH level checked as well to be on the safe side. Thank you.
Expert:  Neuro Doctor replied 3 months ago.

Hi, you are very welcome!

My name is***** MD

Yes seeing a neurologist is a prudent thing to do now because there are neurological/brain issues which can cause his manifestations, like cyst, other structural brain issues etc. And there are medical conditions like vitamin deficiencies too can cause this so this needs to be checked too. It looks like his tsh was okay, so thyroid testing may not be necessary. And yes the calcium calculation the endocrinologist did is correct, so his actual calcium level is not high, but still it is better to repeat a calcium level, and PTH level too – just to be on the safer side.

Once again I fully concur with a thorough neurological evaluation as discussed above (brain MRI, vitamin levels etc), and the calcium level related evaluation too.

You are very welcome!

Best regards!

Expert:  Neuro Doctor replied 3 months ago.

Hi, Please let me know if you have any additional questions or if you want to discuss this further. Please do not forget to click a positive rating for my services to you. If you have follow-up or additional questions you can ask them after the rating too. Best regards! Neuro Doctor

Customer: replied 3 months ago.
Hello Sir,
I just have one last question please.
While I am waiting to get my son in to see the neurologist, would you recommend or think it would be a good ideal for me to start giving him Vitamin B complex? Just in case he is deficient in one of those vitamins? He is away in college and I do not see him often. I can mail the vitamins to him or have him to pick them up at walmart near his school. I don't know how long it is going to take to find a neurologist and for him to get evaluated plus have the mri done. I just want to do whatever i can to help. Since his calcium was elevated, i really don't want to give him any multivitamins with calcuim in it. What do you think we should do while waiting to be seen by a specialist? Thank you.
Expert:  Neuro Doctor replied 3 months ago.

You are very welcome! Yes, I agree with you, vitamin supplementation can be started now. If he is really deficient then it can help him. Unless an appointment is available in the very near future it is better to start the vitamins now itself. And I also agree with you while buying the vitamins it is important it does not contain any calcium.

Customer: replied 3 months ago.
i didn't get your response
Expert:  Neuro Doctor replied 3 months ago.

You mean to say you have not received my reply (which I have posted above several minutes back), or what I have written above is not clear to you?