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Whom To Contact When Diagnosed With A Cyst In The Brain?

Posted on Tue, 26 Apr 2016

Question: Hello, a friend of mine just found out through MRI that she has a cyst on her brain. What doctor would she be referred to first, a neurologist or a neurosurgeon? She has many migrants, with vomiting, so there are symptoms. What would her next step be?

Answered by Dr. Dr. Erion Spaho (1 hour later)

Brief Answer:
Don't loose more time. Neurosurgeon's evaluation needed.

Detailed Answer:
Hello and thanks for using HCM.

I have read your question and understand your concerns.

I could be more of help if you can upload a picture of MRI report, or some of the images.

However, a brain lesion such a cyst that, from what you say, is symptomatic, (regarding to symptoms there may be increased intracranial pressure) requires surgical evaluation and attention, so, your friend shouldn't loose more time and should be referred to a Neurosurgeon.

Hope you found the answer helpful.

Let me know if I can assist you further.

Greetings.

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

Follow up: Dr. Dr. Erion Spaho (27 hours later)

And do they usually drain a symptomatic cyst, or operate? And if they do decide to operate, is this risky, and if so what are the risks?

Is there medication that can just reduce the cyst? I know it is in her frontal lobe..the same spot where she gets migranes

Answered by Dr. Dr. Erion Spaho (8 hours later)

Brief Answer:
Stereotactic evacuation, open surgery.

Detailed Answer:
Welcome back and thanks for being on follow up.

If the cyst you mentioned is found responsible for your friend's symptoms, it needs to be treated surgically.

Options include stereotactic evacuation of cyst contents, open surgery with complete removal, shunting of cyst contents also.

This needs to be evaluated by your friend's attending Neurosurgeon.

Of course that there are risks with neurosurgical procedures and these include hemorrhage, infection, anesthesia complications etc.

The risks for complications by numbers is around 1%.

Hope this addresses your query sufficiently.

Take care.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Dr. Erion Spaho (3 days later)

Hello,

I'm not sure how to upload the copy of her MRI, but I will relay the parts that are "not normal"..

Cerebral Hemispheres: There is a a focus of FLAIR hyperintesity identified at the anterior limb of the right internal capsule and this is measured at 5mm. There were other tiny foci at the subcortical focal matter measuring a couple of mm. There areas didn't show any restriction of diffusion. No mass. No area of edema. No diffusion.

There is a linear area of increased signal intensity identified on the ADC map, diffusion weighted imaging at the right frontal parietal brain. The appearance suggests a small cyst. It could represent a small vascular structure however

Suggest follow up with arteiovenious malformation protocol. The patient will be recalled for this study. "

Answered by Dr. Dr. Erion Spaho (17 hours later)

Brief Answer:
Arteriography of brain vessels needed.

Detailed Answer:
Welcome back.

The cyst that you were referring in our previous discussion, isn't still diagnosed about its exact nature, regarding to MRI report you uploaded.

It is necessary for further imaging investigation such arteriography (DSA) in order to have a correct diagnosis ( since its vascular nature is possible due to MRI report ).

Increased FLAIR signal could be related to uncontrolled high blood pressure ( if any ), or degerative neurological disorder, clinical correlation by a Neurologist is needed for this purpose.

Hope I helped you.

Take care.

Above answer was peer-reviewed by : Dr. Yogesh D