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What Causes Right-sided Numbness When Diagnosed With Cervical Stenosis And Meningioma?

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Posted on Mon, 9 Nov 2015
Question: My wife was diagnosed with both a cervical stenosis and a meningioma about a year ago. She underwent radiological treatment for the meningioma. She has had weakness on her left lower extremities for a long time but this past weekend she woke up with numbness on her right side, numbness on the right side of her face and tongue that is more severe than her left side. She must concentrate heavily to walk, hold something in her hand
doctor
Answered by Dr. Olsi Taka (8 hours later)
Brief Answer:
Possible stroke

Detailed Answer:
I read your question carefully and I understand your concern.

From your description it seems that this worsening of neurological symptoms on the right side was installed in an abrupt manner as opposed to gradually over months, or as a remnant of radiology treatment.

In that case I would say that meningioma growth seems to be a less likely cause for her symptoms (unless there is a hemorrhage inside the tumor but that is a rare occurrence). If appeared in an abrupt manner a stroke is the most likely cause. It's not clear what do you mean by cervical stenosis, stenosis of the spinal cord canal or stenosis of the neck vessels. If the second case then that makes stroke even more likely as stenosis of neck vessels from atherosclerotic plaques is one of the most common causes of stroke (but even if you didn't mean the vessels, before an abrupt neurologic deficit stroke is the most likely).

So I would recommend brain imaging preferably with MRI to confirm the diagnosis in order to decide on further tests and treatment to prevent another stroke from happening.

I remain at your disposal for other questions.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Olsi Taka (7 hours later)
Thank you very much for your response

She has a spinal stenosis

The old adage "never ask a question to which you do not want to hear the answer" is very much on her mind. I will do my best to get her to go to the neurologist ASAP. At least she will talk to me about her symptoms and that is a step in the right direction.

Since the onset on her right side was abrupt, affecting muscles, sensory systems and her conscious thought, it does sound like neither the compression on her spine nor the meninginoma may be the root cause, but perhaps a blockage in the carotid or some other blood flow issue may be the root cause of the problem

Again thank you and please share any additional thought
XXXXX
doctor
Answered by Dr. Olsi Taka (1 hour later)
Brief Answer:
Read below

Detailed Answer:
Hello again and thank you for the kind words.

Regarding additional thoughts, well my main hypothesis remains the same, when in front of an abrupt neurological deficit the first cause is stroke, whether ischemic or hemorrhagic (the latter can be due to meningioma on rare occasions) is differentiated with confidence only by imaging.
If it was a transitory episode with symptoms regressing inside 24 hours then an additional hypothesis might be a seizure (possible in patients with a meningioma) but in that case the deficit should be reversible in 24 hours at most (and medical attention with imaging, EEG and antiepileptic treatment is required – can’t avoid the neurologist).

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Olsi Taka

Neurologist

Practicing since :2004

Answered : 3673 Questions

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What Causes Right-sided Numbness When Diagnosed With Cervical Stenosis And Meningioma?

Brief Answer: Possible stroke Detailed Answer: I read your question carefully and I understand your concern. From your description it seems that this worsening of neurological symptoms on the right side was installed in an abrupt manner as opposed to gradually over months, or as a remnant of radiology treatment. In that case I would say that meningioma growth seems to be a less likely cause for her symptoms (unless there is a hemorrhage inside the tumor but that is a rare occurrence). If appeared in an abrupt manner a stroke is the most likely cause. It's not clear what do you mean by cervical stenosis, stenosis of the spinal cord canal or stenosis of the neck vessels. If the second case then that makes stroke even more likely as stenosis of neck vessels from atherosclerotic plaques is one of the most common causes of stroke (but even if you didn't mean the vessels, before an abrupt neurologic deficit stroke is the most likely). So I would recommend brain imaging preferably with MRI to confirm the diagnosis in order to decide on further tests and treatment to prevent another stroke from happening. I remain at your disposal for other questions.