Author Topic: What is the percentage of Acoustic Neuroma regrowth?  (Read 7471 times)

ANSydney

  • Hero Member
  • *****
  • Posts: 651
Re: What is the percentage of Acoustic Neuroma regrowth?
« Reply #15 on: November 15, 2018, 03:56:28 pm »
Measurement Error is the difference in size between reported size and actual size. Factors that influence reported size is operator differences and MRI slice position. Slice position refers to the plane along which the MRI takes its image. If it through the maximum diameter it will indicate the size, however if it half-a-slice either side it will show a smaller reading.

In summary a reported difference in 2 mm may not be growth at all.

(We haven't gone into interpretation differences about where to measure the tumor.)

Crazycat

  • Hero Member
  • *****
  • Posts: 788
  • Self-Portrait/ "Friends, Romans, countrymen...."
Re: What is the percentage of Acoustic Neuroma regrowth?
« Reply #16 on: November 17, 2018, 11:43:13 pm »
Thank you Syd!

Here's a partial transcription of my MRI exam last week. It's like something from the '60s sci-fi film "Fantastic Voyage".

What concerns me the most is: "Incidental note is made of a small, developmental venous anomaly in the left frontal lobe",
which could be an indication of a potential stroke or aneurysm. At any rate, the radiologist didn't seem to be too concerned about it.


Indication: Follow-up of vestibular schwannoma.

Comparison: Multiple brain MRIs dating back to 8/17/2011 with the most recent performed on 9/13/2017.

Findings: Redemonstrated is the multilobulated, avidly enhancing left cerebellopontine angle mass with cystic components. The prepontine component measures approximately 1.8 x (CC) 1.9 (AP) x 3.8 (TV) cm (measured approximately 1.8 x 1.8 x 3.8 cm in 2017 and 1.7 x1.5 x 3.7 cm in 2011). The component at the foramen of Luschka measures approximately 1.9 x 1.7 x 1.3 cm (measured approximately 1.8 x 1.8 x 1.4 cm in 2017, 1.7 x 1.3 x 0.9 cm in 2011). Exerted mass effect and partial effacement of the left prepontine cistern and cerebellopontine angle are similar to prior.

Postoperative change of the posterior fossa is remonstrated with left cerebellar encephalomalacia, and left suboccipital craniectomy with mesh cranioplasty (I have a titanium mesh at the back of my skull).

Shunt catheter placed via the right frontal approach terminates in the anterior horn of the right lateral ventricle near the foramen of Munro, similar to the prior examinations. Small halo of T2 FLAIR hyperintense signal along the shunt tract is also similar to prior. There is no ventriculomegaly or sulcal effacement. Ventricles, sulci and cisterns appear similar to 2011.

There is no restricted diffusion, acute infarct or parenchymal hemorrhage. Incidental note is made of a small, developmental venous anomaly in the left frontal lobe.

There is no focal extra-axial collection.

There is smooth,diffuse dural enhancement.

The major vascular voids are intact.

There is minimal mucosal thickening of the paranasal sinuses with a small mucous tension cyst at the right maxillary sinus floor. Mastoid air cells are clear. Left mastoid air cells are underpneumatized.

Globes and orbits appear normal.

Nasopalatine duct cyst is remonstrated.

Impression:

1. Left cerebellopontine angle mass presumed to reflect vestibular shwannoma is similar to 2017. When compared to the more remote examination from 2011, there has been slight, gradual increase in size.

2. Smooth, diffuse dural enhancement most likely reflects intracranial hypotension (overshunting). Shunt catheter tip location, ventricles, sulci and cisterns appear similar to 2011.

5cm x 5cm left-side A.N. partially removed via Middle Fossa 9/21/2005 @ Mass General. 
Compounded by hydrocephalus. Shunt installed 8/10/2005.
Dr. Fred Barker - Neurosurgeon and Dr. Michael McKenna - Neurotologist.

ANSydney

  • Hero Member
  • *****
  • Posts: 651
Re: What is the percentage of Acoustic Neuroma regrowth?
« Reply #17 on: November 19, 2018, 04:27:48 pm »
Let's see what we have:

2018: 1.8 (CC) x 1.9 (AP) x 3.8 (TV) cm
2017: 1.8 (CC) x 1.8 (AP) x 3.8 (TV) cm
2011: 1.7 (CC) x 1.5 (AP) x 3.7 (TV) cm

The dimension with a significant difference is the AP dimension. The other two dimensions are effectively unchanged.

Have you taken a look at you images on CD?

Crazycat

  • Hero Member
  • *****
  • Posts: 788
  • Self-Portrait/ "Friends, Romans, countrymen...."
Re: What is the percentage of Acoustic Neuroma regrowth?
« Reply #18 on: November 20, 2018, 10:45:01 pm »
No, haven't viewed the CD yet. For some reason, the radiologist hit the panic button last year, prompting me to book appointments with my doctors at Mass General. Turns out the bigger concern has to do with overshunting. The regrowth is so slight there is really no need for additional treatment at this point. It really hasn't changed at all since my 2017 scan and there is nothing that can be done about the overshunting.

Though I have been feeling the effects of having less pressure in my head as my brain tissue is billowing out against the inside of the skull. I have headaches and my nerves are shot. Just tonight someone walked came up behind me in the driveway and surprised me. I couldn't hear him approaching as I am deaf as a post. I was in the process of scraping ice off the windshield. I turned and raised the ice scraper over my head like I was going to club him. It scared the hell out of me—the way I reacted.
5cm x 5cm left-side A.N. partially removed via Middle Fossa 9/21/2005 @ Mass General. 
Compounded by hydrocephalus. Shunt installed 8/10/2005.
Dr. Fred Barker - Neurosurgeon and Dr. Michael McKenna - Neurotologist.

 


anything