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What is a granuloma and is it related to stroke?

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Practicing since : 2002
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concernes about ct of head : 1) no recent cerebral hemorrage , CVA seen 2) calcification seen occiptal lobe unchanged in size and may represent granuloma 3)no mass effect with edema noted. I HAD THIS DONE JULY 2010 i am very nervous and i remember that day i went to er for a headache but they never told me about the cCVA that came up on my CT of head. should i be concerned , they sent me home that day and didnt mention this I HAD A STROKE???.. WHAT IS GRANULOMA? I have a pineal cyst 9mm for 5 years but as far as i know as long as the cyst as not changed i am ok. i just had mri of brain but no ct since last year can mri detect anything like cva.. sorry but very concerned that supposedly i had a stroke (cva) i had no symtoms ?? what should i do? can i have another cva? PLEASE HELP i dont have a neuro yet and now with the report form last year that i have a copy of now says cva i am nervous.
Posted Tue, 8 May 2012 in Stroke
Follow-up: What is a granuloma and is it related to stroke? 8 minutes later
i forgot on recent mri of brain my pineal cyst is unchanged but is alos said
promienet pitiuary , this is probably at the upper limits of normal , if clinical concern get dedicated pituatary study. , there is no definite mass . gland measure 9mm h 13-14 mm transverse -however gland is convex upward which is less typical. endocrinologic is suggested. i need referrals from my primary care is this urgent ?
Answered by Dr. Robert Galamaga 32 minutes later

Thank you for your query.

I can understand that you are quite concerned about the results of your imaging studies so let's step back and take a look once again at each of the results. I honestly suspect that the transcriptionist may have made a typographical error in the report. I suspect the radiologist might have been saying "No CVA seen" or "No recent cerebral hemorrhage or CVA seen." Do you have an actual scanned copy of the report? If so, if you could email it to my attention at YYYY@YYYY I can review it to make sure this is the case and help set your mind at ease.

Calcifications are not uncommon to pick up on a CT scan and usually are not indicative of any worrisome process. A granuloma is a benign collection of cells which are similar to a small scar - they don't cause problems or transform into anything more worrisome such as cancer. Granulomas again are commonly found on imaging studies.

I am glad you have had the followup MRI. MRI can certainly pick up findings of a previous CVA which, in light of your recent MRI findings, makes me even more confident that you did not have a CVA in the past.

I don't think you have an urgent issue at all here. You can seek a referral from your PCP but I suspect specialists will advocate followup with imaging in another year to document stability of the previous MRI findings - especially if you are otherwise asymptomatic at this point.

I really hope my answer has been adequate and informative for you. I am available for your followups.


Dr. Galamaga
Above answer was peer-reviewed by
Follow-up: What is a granuloma and is it related to stroke? 1 hour later
i emailed you my scans pdf format attached files sorry seperate pages 4 pages all together i scanned them to you , please reply
Answered by Dr. Robert Galamaga 34 minutes later
Hello again and thanks for sending the report.

As I suspected - you did NOT have a CVA. This is excellent news. The wording of the report is such that I can understand how you might misinterpret the radiologists impression.

Let me reassure you that the comments regarding the CSF are also not alarming. These are just comments related to the density of the tissue which he is describing. As for the headaches and symptoms you have, I would recommend you seek the advice of a neurologist who can examine you and offer you potential treatment options. The findings on your MRI are stable or virtually unchanged from the previous study which is also reassuring.

Try to relax and take this one step at a time. Discuss with your doctor and consider asking for a neurology referral for an expert opinion regarding the headache symptoms you have.

I again hope I have been helpful to you. I wish you all the best.

Dr. Galamaga
Above answer was peer-reviewed by
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