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What Do My MRI Test Results Indicate?
Question: Hello Doctor,
I am 20 y/o male. I have environmental allergies but otherwise generally healthy. In the beginning of the year my blood test showed slightly elevated Prolactin 27.7 (range 2.2-18.5). All other standard and additional tests like Estradiol, Testosterone, LH, T4, T3, TSH, Glucose, Lipid Panel, Beta HCG, Comprehensive Metabolic Panel were normal. My doctor referred me to do the brain MRI (with and without contrast) to eval the pituitary. The gland appeared to be normal but something else was found. Here is what it says:
Sella: Normal pituitary gland, stalk, and optic apparatus.
Parasellar structures: Normal cavernous sinuses and carotid artery flow voids.
Parenchyma: There is a large likely developmental venous anomaly within the parasagittal right frontal lobe in the superior frontal gyrus. A component of this courses into the anterior horn of the right lateral ventricle. No acute hemorrhage, infarction, mass, or abnormal enhancement.
Ventricles and extra-axial spaces: Appropriate for age.
Orbits: Normal.
Visualized paranasal sinuses: Pan paranasal sinus mucosal thickening
Mastoid air cells: Clear.
Bones: Normal.
Additional comment: None.
Impression
1. No discrete lesion of the pituitary is identified.
2. Incidental note of a large developmental venous anomaly within
the right superior frontal gyrus.
3. Mild pan paranasal sinus mucosal thickening may be congestive or
inflammatory.
I would like to ask your opinion about the developmental venous anomaly. Can it be related to the Prolactin issue? Are people born with this anomaly or it develops over time (if so, what causes it) or it is hereditary? My mom was very careful when pregnant with me, she didn’t take any meds, drink, smoke. However, she had to be induced to deliver me, could the injection cause it? How dangerous this condition it? More chances to have stroke, aneurism or any other issue? Anything I can do to treat it or keep it stable? Can it expand? By residing in a certain part of the brain does it affect my personality, skills, behavior etc? I am in college, does drinking or smoking pot can do me more harm than other people my age? Does being on the plane or skiing at high altitude make my condition worse?
Thank you for your consultation!
I am 20 y/o male. I have environmental allergies but otherwise generally healthy. In the beginning of the year my blood test showed slightly elevated Prolactin 27.7 (range 2.2-18.5). All other standard and additional tests like Estradiol, Testosterone, LH, T4, T3, TSH, Glucose, Lipid Panel, Beta HCG, Comprehensive Metabolic Panel were normal. My doctor referred me to do the brain MRI (with and without contrast) to eval the pituitary. The gland appeared to be normal but something else was found. Here is what it says:
Sella: Normal pituitary gland, stalk, and optic apparatus.
Parasellar structures: Normal cavernous sinuses and carotid artery flow voids.
Parenchyma: There is a large likely developmental venous anomaly within the parasagittal right frontal lobe in the superior frontal gyrus. A component of this courses into the anterior horn of the right lateral ventricle. No acute hemorrhage, infarction, mass, or abnormal enhancement.
Ventricles and extra-axial spaces: Appropriate for age.
Orbits: Normal.
Visualized paranasal sinuses: Pan paranasal sinus mucosal thickening
Mastoid air cells: Clear.
Bones: Normal.
Additional comment: None.
Impression
1. No discrete lesion of the pituitary is identified.
2. Incidental note of a large developmental venous anomaly within
the right superior frontal gyrus.
3. Mild pan paranasal sinus mucosal thickening may be congestive or
inflammatory.
I would like to ask your opinion about the developmental venous anomaly. Can it be related to the Prolactin issue? Are people born with this anomaly or it develops over time (if so, what causes it) or it is hereditary? My mom was very careful when pregnant with me, she didn’t take any meds, drink, smoke. However, she had to be induced to deliver me, could the injection cause it? How dangerous this condition it? More chances to have stroke, aneurism or any other issue? Anything I can do to treat it or keep it stable? Can it expand? By residing in a certain part of the brain does it affect my personality, skills, behavior etc? I am in college, does drinking or smoking pot can do me more harm than other people my age? Does being on the plane or skiing at high altitude make my condition worse?
Thank you for your consultation!
Brief Answer:
It is a generally benign anomaly.
Detailed Answer:
I read your question carefully and I understand your concern. I hope that my answer will serve to ease your worries.
The venous anomaly found on the MRI has no relation to the Prolactin issue, it is a coincidental finding.
People are born with this anomaly, so you have always had it. It is not hereditary.
It is created during the intrauterine life, as the venous circulation is developed, the division of some veins is arrested. So it has been already created before birth, the way you were delivered doesn't have anything to do with it. Nor is there any known relation to anything your mother might have had or done.
It is thought to be the most common anomaly, although figures are uncertain as they usually cause no symptoms and in many people may not be detected at all for all their life (like yourself till now), with more and more imaging being had these days it has been noted to be much more frequent than once thought.
Because it is made up only of veins the pressure within is low, therefore it is generally not dangerous, doesn't rupture and doesn't cause any symptom if isolated (unless there is some other accompanying anomaly which may happen in 15-20% of cases - but not seen on your MRI).
In very few cases it may lead to a predisposition for seizures. In even fewer cases it may lead to a hemorrhagic stroke. The risk is very low though, about 0.15% per year when isolated.
Because the risk is so small generally no intervention is required to deal with it, it is left as it is. There is nothing you need to do to keep it stable and it won't expand.
It shouldn't affect your brain functioning as the brain matter in the area is normal, blood supply is not compromised.
Substance abuse in itself doesn't affect it directly. Indirectly because they may lower seizure threshold they could increase seizure risk.
As for flying or skiing they shouldn't affect it and you may pursue those activities.
I remain at your disposal for other questions.
It is a generally benign anomaly.
Detailed Answer:
I read your question carefully and I understand your concern. I hope that my answer will serve to ease your worries.
The venous anomaly found on the MRI has no relation to the Prolactin issue, it is a coincidental finding.
People are born with this anomaly, so you have always had it. It is not hereditary.
It is created during the intrauterine life, as the venous circulation is developed, the division of some veins is arrested. So it has been already created before birth, the way you were delivered doesn't have anything to do with it. Nor is there any known relation to anything your mother might have had or done.
It is thought to be the most common anomaly, although figures are uncertain as they usually cause no symptoms and in many people may not be detected at all for all their life (like yourself till now), with more and more imaging being had these days it has been noted to be much more frequent than once thought.
Because it is made up only of veins the pressure within is low, therefore it is generally not dangerous, doesn't rupture and doesn't cause any symptom if isolated (unless there is some other accompanying anomaly which may happen in 15-20% of cases - but not seen on your MRI).
In very few cases it may lead to a predisposition for seizures. In even fewer cases it may lead to a hemorrhagic stroke. The risk is very low though, about 0.15% per year when isolated.
Because the risk is so small generally no intervention is required to deal with it, it is left as it is. There is nothing you need to do to keep it stable and it won't expand.
It shouldn't affect your brain functioning as the brain matter in the area is normal, blood supply is not compromised.
Substance abuse in itself doesn't affect it directly. Indirectly because they may lower seizure threshold they could increase seizure risk.
As for flying or skiing they shouldn't affect it and you may pursue those activities.
I remain at your disposal for other questions.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you very much Dr. Taka. Yes, you definitely eased my concerns.
When I was born I had a small angioma on my shoulder which is almost invisible now. Is it a similar thing to the developmental venous anomaly? Just curious. My grandfather has a very bad veins in his legs, does this somehow relate to the problem I have?
Does it matter if the anomaly size is large, like in my case, or small?
I am in a very academically advanced college and I do have a lot of stress. I know stress is not good, does having the anomaly and stress increase my risk factors?
You mentioned that there may be some accompanying anomaly conditions, that are not seen on my MRI, can you give me a few the most common ones?
I asked of whether the developmental venous anomaly may affect someone’s personality because I am a XXXXXXX man and was wondering if it may have anything to do with it.
Thank you again! Appreciate your advise.
When I was born I had a small angioma on my shoulder which is almost invisible now. Is it a similar thing to the developmental venous anomaly? Just curious. My grandfather has a very bad veins in his legs, does this somehow relate to the problem I have?
Does it matter if the anomaly size is large, like in my case, or small?
I am in a very academically advanced college and I do have a lot of stress. I know stress is not good, does having the anomaly and stress increase my risk factors?
You mentioned that there may be some accompanying anomaly conditions, that are not seen on my MRI, can you give me a few the most common ones?
I asked of whether the developmental venous anomaly may affect someone’s personality because I am a XXXXXXX man and was wondering if it may have anything to do with it.
Thank you again! Appreciate your advise.
Brief Answer:
Read below.
Detailed Answer:
Hello again.
The cutaneous angiomas are of a different nature as they most commonly are not comprised of veins, but of capillary or lymphatic vessels. So it is a little different while just as benign.
As for your grandfather veins there is no relation no, in his case (I am assuming varicose veins) it is a question of a normal venous architecture but where the vessels have lost their tonicity and are dilated.
In theory a larger size might increase the risk of seizure....but remember that since you haven't had them for 20 years there is no reason to think you will now just because of a MRI you had for a whole other purpose.
I do not think stress increases the risk. As I said before with blood vessel anomalies the risk is higher when arteries are involved, where the pressure is much higher and in theory anything which might affect blood pressure (stress included) might increase the risk somewhat. In the veins though the blood flows at a low pressure so not influenced much by external factors.
By other accompanying anomalies I mean vascular ones with higher risk of hemorrhage such as cavernous malformation, arteriovenous malformation or of the brain matter like cortical dysplasia (higher risk of seizures).
Before making link between homosexuality and venous anomalies you should remember that there is no clear accepted mechanism for homosexuality, it's not like it has been linked to any particular brain area lesion, so since science hasn't got that covered how can such relationships be made. However in my view the answer is no, there shouldn't be any connection.
Let me know if I can further assist you.
Read below.
Detailed Answer:
Hello again.
The cutaneous angiomas are of a different nature as they most commonly are not comprised of veins, but of capillary or lymphatic vessels. So it is a little different while just as benign.
As for your grandfather veins there is no relation no, in his case (I am assuming varicose veins) it is a question of a normal venous architecture but where the vessels have lost their tonicity and are dilated.
In theory a larger size might increase the risk of seizure....but remember that since you haven't had them for 20 years there is no reason to think you will now just because of a MRI you had for a whole other purpose.
I do not think stress increases the risk. As I said before with blood vessel anomalies the risk is higher when arteries are involved, where the pressure is much higher and in theory anything which might affect blood pressure (stress included) might increase the risk somewhat. In the veins though the blood flows at a low pressure so not influenced much by external factors.
By other accompanying anomalies I mean vascular ones with higher risk of hemorrhage such as cavernous malformation, arteriovenous malformation or of the brain matter like cortical dysplasia (higher risk of seizures).
Before making link between homosexuality and venous anomalies you should remember that there is no clear accepted mechanism for homosexuality, it's not like it has been linked to any particular brain area lesion, so since science hasn't got that covered how can such relationships be made. However in my view the answer is no, there shouldn't be any connection.
Let me know if I can further assist you.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you very much for your consultation!
Brief Answer:
You're welcome.
Detailed Answer:
Glad to have been of help.
You're welcome.
Detailed Answer:
Glad to have been of help.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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