ANA Discussion Forum
General Category => AN Issues => Topic started by: proudmomof3 on May 27, 2013, 03:22:58 pm
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Hi All,
I am 2 years post Gamma Knife. I am not a regular here anymore, though I should be as my 'problems' haven't stopped once I received GK. But I would just be constantly complaining :-\, and who wants to hear that??
Anyway, I had my 2 year MRI a few weeks ago. I can't get in to see my surgeon until the end of June (not surprised). Anyway, could anyone translate this Impression from the MRI:
" Right IAC vestibular schwannoma with extension into the CP angle cistern. There is contact with cerebellar peduncle. No significant changes from prior MRI."
Here are my questions:
1) What does "extension into CP angle cistern and contact with cerebellar peduncle mean?
2) There is absolutely no mention of AN darkened at all or shrinking. The last 2 MRI's mentioned "darkening". This one didn't. They did do it with and without contrast. It also appears to be the same size as it was 2 years ago. Is this normal?
If anyone could help me out with this I would greatly appreciate it. I am really stressed about it and I have to wait another month to see my Neuro.
thanks so much!!
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Actually this sounds like a good (aka boring) report, considering that your treatment was 2 years ago.
The first two phrases typically characterize an AN which extends into the CP angle (i.e. not confined inside the IAC). These are always in contact with the cerebellar peduncle. The most important finding is that there are no significant changes. As the goal of radiosurgery is generally to arrest the growth (i.e. maintain a stable size) this is positive. Shrinkage is an added bonus but does not happen necessarily (only in about a third of cases).
Darkening is typically seen during the first 6-12 months, but then disappears, because of the formation of scar tissue.
Of course you should ask your surgeon about all this when you see him, but in the meantime there is nothing unusual to be stressed about.
Marianna
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Of course you should ask your surgeon about all this when you see him, but in the meantime there is nothing unusual to be stressed about.
Marianna
Thanks Marianna. I feel better now. I thought the AN was inside the ear canal and did not go past that. I have never seen on the reports before where it "extends" into another location. I don't know if that means it has grown or swollen, or if it was originally like that and they never mentioned it.
Thanks
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Sounds like a pretty normal 2 year MRI to me.
It's really just describing your tumour in words and it sounds very normal for one that's not real big.
Of course please speak to your neurosurgeon.
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Hello;
To my knowledge, "cerebellar pundacle" is at the brain stem? So, I'm confused.
CPA cistern is entering the CPA from the IAC.
They may not mention "darkening" as the latest MRI is in comparison to the last.
Maybe sit down with your Dr. and have him explain this report in layman's language?
At least there was no growth!
Best wishes here ...
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To my knowledge, "cerebellar pundacle" is at the brain stem? So, I'm confused.
CPA cistern is entering the CPA from the IAC.
That is what I was wondering??? I do not think the tumor was outside of the IAC. Now it states that it is extended into CPA and cerebellar pundacle. I recall my last visit with dr a year ago, and he specifically said that it was only in the IAC. So why does this MRI mention those other things?
I know I need to ask the dr about this, but I have to wait until June 25th. I was just wondering if anyone knew if the tumor is now outside of the IAC and touching the brain stem??
Thanks
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I know I need to ask the dr about this, but I have to wait until June 25th.
Have you actually seen the images from all of your MRIs?
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Of course we are not doctors, but in my understanding cerebellar peduncle is not part of the brain stem, rather connects the cerebellum to the pons (which is part of the brain stem).
Sometimes radiologists use more technical and medically accurate terminology, whereas a surgeon may oversimplify things to make them easier to understand. Also the writing style varies from radiologist to radiologist. Perhaps the tumor was mainly confined in the IAC, so your surgeon didn't bother mentioning the portion that extends in the CPA. Since you had GK, you must have had a detailed MRI back then. Can you find the radiologist report from back then and compare it?
The report states clearly that there is no change compared to the previous MRI. I would think that if there was a significant change, for sure the radiologist would have mentioned it.
Marianna
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The most important thing is the phrase no significant change. I read radiology reports nearly every day at work and find that there is some variation in the description of a scan or image between different radiologists. Also, if a different MRI machine was used or a newer one than 2 years ago with better resolution (clearer pictures), the reports can vary slightly as far as size, etc.
Waiting is hard, but hang onto the words no significant change.
When you see your surgeon, ask him to show you the actual scan images and compare from 2 years ago.
Good luck.