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drknowsbest, Doctor
Category: Health
Satisfied Customers: 1496
Experience:  DO board certified family practitioner spec. in womens health
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I had an brain MRI done last week and the results read as

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I had an brain MRI done last week and the results read as follows:
The ventricles are normal in size. Subarachnoid spaces are prominent towards the vertex. A 1 cm pineal cyst is present. Tissue in the pituitary fossa is asymmetric with CSF signal in the left portion. The pituitary tissue on the left is thin. Intermediate signal tissue is present in the right aspect of the pituitary fossa. The appearance is not that of typical empty sela, raising the question of mass-effect. The cerebellar tonsils are borderline low. Visualized portions of the paranasal sinuses are unremarkable.
What does all of this mean?
Submitted: 5 years ago.
Category: Health
Expert:  drknowsbest replied 5 years ago.
drknowsbest : Ae you there


drknowsbest : Are you having symptoms ?

I have been experiencing pressure type discomfort to the back of my head.

drknowsbest : The cyst doesnt really mean anything what we call incidental finding. The low uptake signal in pituitary needs follow up with a pituitary MRI. This may also be reader dependent and be nothing. Sometimes it is a benign pituitary tumor. These are more usually associated with vision changes and are pretty common. They usually mean nothing but do need follow up and some labs like prolactin, fsh, lh, TSh, t4, t3.
drknowsbest : There is also a question about the mass effect. This means increased pressure or size which would possibly cause the low cerebellum. This is in the back and most certainly could cause headache.
drknowsbest : Have you had An EEG or seen a neurosurgeon?

What do you mean low uptake signal in pituitary? What do you mean reader dependent? Mass effect of what? What does "tissue i the pituitary fossa is asymmetric with CSF signal in the left portion" mean? Yes I am seeing aneurologist and an EEG was done.

drknowsbest : Reader dependent like the read is very wispy washy by the radiologist and another may not see any of this. Mass effect means increased cerebrospinal fluid pressure or mass can increase pressure in the skull and cause brain to move like being squishes.
drknowsbest : Sorry squished
drknowsbest : Okay a cerebrospinal fluid study can rule out some causes
drknowsbest : These could be benign tumor in pituitary. Something called Arnold chiari malformation, and pseudo tumor cerebri.
drknowsbest : These are all pretty complicated to explain but in short could cause your headache, and can only be found with the studies I mentioned

So the mass effect thing is serious?

drknowsbest : A ct myelogram can detect a fluid leak which is rare but could also cause headache.
drknowsbest : If certain Arnold chiari types yes, require surgery but correctable. Don't panic, many more tests need to be done and the fact no tumor seen on MRI and no Arnold chiari diagnosed on MRI both very good signs

The MRI impression read " Pineal cyst. Question of arachnoid cyst in the pituitary fossa." Is this common and does it require surgery.

drknowsbest : Monitor a pineal cyst usually no treatment since they don't enlarge or cause symptks
drknowsbest : Symptoms

What about the "question of arachnoid cyst in the pituitary fossa"?

drknowsbest : The arachnoid in the pituitary may be what is affecting the look of the gland on the MRI and that's why you need the pituitary MRI to get a better look, some educate they can cause headache but may cause no symptoms usually not a problem

So what do you see as the most area of concern with my results - the question of mass effect?

drknowsbest : If it gets larger you'd most likely get visual changes and this would be the only time intervened
drknowsbest : Yes the rule out of the mass effect

Is it serious?

drknowsbest : Not yet, honestly, it could be but more likely with no other significant findings its not just means more testing for now

What type of testing?

drknowsbest : If no more questions pleas press accept to exit
drknowsbest : The ones I mentioned above

Thank you.

drknowsbest : Sure good luck
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