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What Does The Following MRI Scan Report Indicate?

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Posted on Tue, 14 Jun 2016
Question: Hi my 11 yr old son who had sporadic headaches had an MRI - findings were predominantly normal with increased T2 signal suggestive of fluid in the right petrous apex region. Mastoid air cells normally aerated and the finding is of unclear significance. Recommendation is CT of the temporal bones . He has seen an ENT who upon physical exam - found him to be completely normal . Dr said i could wait on ct.
I am still so anxious and nervous. Could it be just trapped fluid?
doctor
Answered by Dr. Indu Kumar (18 minutes later)
Brief Answer:
Infection in petrous part of temporal bone generally indicates infection.

Detailed Answer:
Hello,
Thanks for writing to HCM,
I've gone through your query and understand your concern,

Infection in petrous part of temporal bone generally indicates infection.
Mastoid air cells may be normal in acute infection. It may take some time for loss of aeration in mastoid bone which may then indicate chronic infection.

HRCT is important your son. It will help in detailed evaluation.
This is generally not a very serious finding and your son may need conservative treatment in the form of antibiotics etc.

There is no need to panic. We should wait for HRCT of temporal bones.

Get well soon.

Hope I have answered your query.
Further queries are most welcome.

Take Care
Dr. Indu XXXXXXX
Above answer was peer-reviewed by : Dr. Sonia Raina
doctor
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Follow up: Dr. Indu Kumar (30 minutes later)
Thank you for responding so quickly . I hope to have the HRCT scheduled in 10 days from now . In the meantime we are supposed to fly on an airplane out-of-state In a few days for vacation is this safe for him or should i press the dr for antibiotics now while i wait for test?
doctor
Answered by Dr. Indu Kumar (1 hour later)
Brief Answer:
You can wait for 10 days and enjoy vacations.

Detailed Answer:
Hello,
Thanks for writing to HCM,

You can wait for 10 days and enjoy vacations.
Empirically antibiotics may be prescribed after clinical evaluation.Don't insist for medicines,this need clinical evaluation also.

Get well soon.

Hope I have answered your query.
Further queries are most welcome.

Take Care
Dr. Indu XXXXXXX
Above answer was peer-reviewed by : Dr. Sonia Raina
doctor
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Follow up: Dr. Indu Kumar (34 hours later)
One last question - is there an increased risk for headache and or vomiting in flight due to the pressure from the fluid ? And if so should Tylenol and Sudafed before help ?
doctor
Answered by Dr. Indu Kumar (20 hours later)
Brief Answer:
Patient may have headache and paracetamol will be more helpful.

Detailed Answer:
Hello,
Thanks for writing to HCM,
Sorry for replying late

Patient may have headache and paracetamol will be more helpful in this condition.

Get well soon.

Hope I have answered your query.
Further queries are most welcome.

Take Care
Dr. Indu XXXXXXX
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Indu Kumar (14 days later)
Good evening Dr. XXXXXXX

I am following up just for guidance on the specialty of doctor I should be seeing. The HRCT came back with the same findings and impressions as the MRI which is patchy fluid in the petrous region of the temporal bone. But no bony erosion, no expansion. All else appears to be normal findings in the report - except a high riding right jugular bulb is noted. He appears fine except that his headache frequency in the last two weeks has increased to every 3 days (From every 10-14 days). Still mild, not much pain but in forehead. My concern is his neuro is unsure of next steps and his ENT is away on vacation until May 2. to be honest, I'm not even sure his ENT has ever seen this before. My guess is he is used to seeing fluid in the mastoid and/or granulomas but my son has neither.
My preference is to get him seen sooner rather than later. Should my neuro be consulting with a neurosurgeon or the radiologists? Should I proceed with all new doctors? the covering doctor for his ENT looked only at the HRCT report and was not concerned about infection. Not sure who is "expert" per se of the 3 specialties. But I definitely want to speak to someone who has actually seen and diagnosed this before.
Any guidance you could give would be appreciated.

Thanks
doctor
Answered by Dr. Indu Kumar (10 hours later)
Brief Answer:
I think you can take opinion form other neurologist.

Detailed Answer:
Hello,
Thanks for writing to HCM,

I think you can take opinion form other neurologist.They are the best to guide further treatment.
It is good that there is no bony erosion etc which might indicated chronic infection.

There are many other causes of headache,all causes should be investigated.

Get well soon.

Hope I have answered your query.
Further queries are most welcome.

Take Care
Dr. Indu XXXXXXX
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Deepak
doctor
Answered by
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Dr. Indu Kumar

Radiologist

Practicing since :2004

Answered : 6729 Questions

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What Does The Following MRI Scan Report Indicate?

Brief Answer: Infection in petrous part of temporal bone generally indicates infection. Detailed Answer: Hello, Thanks for writing to HCM, I've gone through your query and understand your concern, Infection in petrous part of temporal bone generally indicates infection. Mastoid air cells may be normal in acute infection. It may take some time for loss of aeration in mastoid bone which may then indicate chronic infection. HRCT is important your son. It will help in detailed evaluation. This is generally not a very serious finding and your son may need conservative treatment in the form of antibiotics etc. There is no need to panic. We should wait for HRCT of temporal bones. Get well soon. Hope I have answered your query. Further queries are most welcome. Take Care Dr. Indu XXXXXXX