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Dr. Andrew Rynne

Family Physician

Exp 50 years

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How can an MRI scan of the brain be interpreted while having intracerebral lesions?

Answered by
Dr.
Dr. Erion Spaho

Neurologist, Surgical

Practicing since :2004

Answered : 3043 Questions

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Posted on Tue, 24 Jul 2018 in General Health
Question: dear dr
this is XXXX i could not submit at your site
do i need mri contrast now?
sir,the changes in left occured due to lack of sleep behaviour i feel since 8 years
you recommended ct csan of temporal left do i need to focus on some specific area?
pls check my lpicture on your website account with colour on effected area
my left area remains unventillated/yawning is abnormal also
doctor
Answered by Dr. Erion Spaho 6 hours later
Brief Answer:
Further evaluation of your temporomandibular joint.

Detailed Answer:
Hello and thanks for being on follow up.

An MRI with contrast is necessary to evaluate specific intracerebral lesions that are excluded in your case, due to your long history of symptoms and previous imaging findings.

In my opinion, a Ct scan of your temporomandibular joint is necessary, since the last one was done 4 years ago and raised suspicions about the temporomandibular joint degenerative disease.

The area pointed to the picture may represent radiation of the discomfort arising from the temporomandibular joint.

Get back to me after the CT scan result.

Take care.


Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Erion Spaho 16 hours later
Hi, I have provided some attachments. Please review them.
doctor
Answered by Dr. Erion Spaho 30 hours later
Brief Answer:
Tests explained below.

Detailed Answer:
Hello again.

Thanks for providing the additional tests results.

The MRI and PET scan results are fortunately normal.

Fetal origin of the left PCA is not related to any clinical issues, so, it is an incidental finding.

NCCT shows some problems with your sinuses, but the condition seems to be mild.

However, it is necessary to clarify whether these sinuses problems interfere with the Eustachian tube function and drainage or not.

The CT report does not include the left temporomandibular joint structure, so, a review of the CT scan, or a targeted examination of the joint is necessary.

Hope this helps.

Kind regards.
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Erion Spaho 32 hours later
Thanks
doctor
Answered by Dr. Erion Spaho 3 hours later
Brief Answer:
You are welcome.

Detailed Answer:
Hope I helped you.

Feel free to discuss with me about your health issues.

In good health.
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Erion Spaho 4 hours later
Thanks for supporting my sleep is connected with this physical condition on my left side with everyday disturbed sleep since 8years i shall get back with left tmj structure
doctor
Answered by Dr. Erion Spaho 7 hours later
Brief Answer:
Follow up.

Detailed Answer:
Hello again.

In my opinion, both, TMJ dysfunction, or degenerative changes, and Eustachian tube dysfunction should be considered and possible causes of your issues.

Take care.


Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Erion Spaho 12 days later
dear dr ,
please consider ct scans for tmj reports
if you need in cd drive please let me know
regards
XXXX
doctor
Answered by Dr. Erion Spaho 19 hours later
Brief Answer:
Slight degeneration.

Detailed Answer:
Hello again.

I examined the CT images of your temporomandibular joint.

Images you provided show only bony structures and I don't see anything serious about any bone condition such advanced degenerative changes, bone spurs, etc.

There seems to be a difference in the sclerotization of the left mandibular head bone, but it is inconclusive.

The CT you provided does not visualize the meniscus of the TMJ.

For a more accurate evaluation of your left TMJ condition consider arthrocentesis of the joint and TMJ arthroscopy.

Hope I helped you.

Teke care.


Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Erion Spaho 2 hours later
dear dr thanks for reply
i shall look for arthroscopyhere ,is it to be done by dental department or neurosurgeon.pls advise
pressure on left ear tmj area not only causes sleep disturbance makes me awake in night also it referspressure to left ear tube straining left eye slightly and pvery light pain in left jaw too
regards
doctor
Answered by Dr. Erion Spaho 11 hours later
Brief Answer:
Oral and Maxillofacial Surgery.

Detailed Answer:
Welcome back.

Arthrocentesis and arthroscopy examination and treatment of the TMJ is done by the Oral and Maxillofacial Surgery Department.

Hope this helps.

Kind regards.


Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Erion Spaho 2 days later
dear dr,
i m still looking for the doctor for above diagonasis!!
as aresult dental surgeon performed ultrasound today of left TMJ which is normal.
will the above examination advised could be related to my sleep problems?
doctor
Answered by Dr. Erion Spaho 10 hours later
Brief Answer:
Explained below.

Detailed Answer:
Hello again.

Since you are insisting about your left TMJ discomfort is related to the sleep disturbances, I believe you, there should be something wrong with your TMJ.

I don't believe that the ultrasound is conclusive about the diagnosis.

Direct arthroscopy is the best tool to achieve a correct understanding of the TMJ status.

Hope this helps.

Take care.
Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Erion Spaho 33 hours later
dear dr , pls find oral maxillofacial dr diagonasis
ha says before invasive he can see maniscus and other mucles to try mri of tmj
he also gave a chin push exercise against gravity
he also said he need to put a botox injection after mri as n if reqd??
pls advise
doctor
Answered by Dr. Erion Spaho 15 hours later
Brief Answer:
MRI is okay to be done.

Detailed Answer:
Hello again.

I saw the report of the Oral and Maxilofacial Doctor.

He is asking an MRI of the TMJ in two positions, open and closed mouth.

This may help to evaluate any issues with the muscles, meniscus and tendons of the TMJ, so, I think it is okay to have it done.

Botox injections may help in relieving muscles spasms that may contribute to the TMJ dysfunction.

I think that arthroscopic evaluation should be done also after the MRI in order to complete the necessary tests for a correct diagnosis.

Hope this helps.

Regards.


Above answer was peer-reviewed by : Dr. Arnab Banerjee
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