Chronic Sinusitis

Chronic sinusitis can be caused by inflammation of the membranes of the sinus cavity or blockage of the sinus passage way from draining normally. Chronic sinusitis last longer than acute sinusitis. It is also less common than acute sinusitis. It can produce less severe symptoms, but can cause damage to the sinuses.

Some symptoms of chronic sinusitis are as follows:

-drainage of a thick, yellow or greenish discharge
-difficulty breathing through nose
-headache
-sore throat
-nasal congestion
-cough
-facial pain and pressure in forehead, temples, cheeks, nose and behind the eyes

There are some different treatments for chronic sinusitis, they are antibiotics, corticosteroids, decongestants, antihistamines, moisture and humidification.

Chronic sinusitis can be diagnosed several different ways. CT is a better diagnostic test for sinuses than MRI, however, MRI can be done. Nasal and sinus cultures can be done and an allergy test can be done.

For more images on chronic sinusitis go to www.uksdmc.co.uk

Optic Glioma

Optic glioma is one of two most common optic nerve tumors. The other common tumor is optic nerve meningioma. Optic glioma arises from the optic nerve. Optic glioma may only effect one optic nerve or both nerves. These are very uncommon and grow slowly. This type of tumor rarely turn into cancer and usually appear during childhood. Agressive glioma is most common in adults and benign optic glioma are most often in younger patients.

Symptoms are the following:
reduce vision
vision loss in one or both eyes
involuntary eye movement
one or both eyes may bulge out

MRI is better to demonstrate optic glioma but CT can also be used.

Treatment are the following:
Surgery
Radiation therapy
Chemotherapy

If you want to learn more about the above photos you can visit webeye.ophth.uiowa.edu and www.fleni.org.ar.

Pituitary Microadenoma

Pituitary Microadenoma

This type of pituitary tumor is a non-cancerous or benign growth. These tumors are smaller than 10 mm in size. Most pituitary tumors are usually microadenomas.

There are several types of Pituitary Microadenomas. They are broken down into two different categories, depending on if they produce hormones or not.
1. Functioning pituitary microadenoma
2. Nonfunctioning pituitary microadenoma

Functioning microadenomas produce one or more of the pituitary hormones. There are different types of Functioning Pituitary micradenomas and each type caused different symptoms.
ACTH producing
Thyroid hormone producing
Growth hormone producing
Prolactin producing

Nonfunctioning pituitary microadenomas do not produce hormones.

Symptoms range from anywhere to being tired, headaches, dizziness and vomiting. These will vary depending on the size of the microadenoma and the location.

MRI and CT scans are both good test, along with others to help diagnose pituitary microadenomas.

Treatment also varies on the type of microadenoma, hormone activity, how big it is and the location of it. Some treatment can include therapy, surgery and radiation therapy.

I have never seen this type of pathology while working in MRI. If you want more information about microadenoma and the pictures above, visit www.ghettodriveby.com,

Acoustic Neuroma

Acoustic Neuroma is a noncancerous or benign tumor of the 8th cranial nerve. Acoustic Neuroma is also called Vestibular Schwannoma. This type of tumor is usually slow growing. The exact cause of Acoustic Neuroma is unknown. The few patients I have seen in MRI that presented with hearing loss and ringing in their ear's turned out to be negative, which is great.

Other Symptoms include:

continuous inner ear problems
difficulty in balance
dizziness
ear pressure
hearing loss
ringing in ear (tinnitus)

MRI and CT are great test that patients with these symptoms can have to help diagnose Acoustic Neuroma.

Treatment can range from anywhere to just observation, to surgery or radiation therapy. Since these tumors are benign, some patients may just want to keep an eye on it over time depending on patients age and size of tumor. Other patients may choose to have surgery to remove the tumor. Some may choose radiation therapy, rarely does this get rid of the tumor but shrinks the tumor. Most patients that have radiation therapy have to follow-up because the tumor could continue to grow.

For more information on the images you can to these web sites: www.neuro.utmem.edu and www.cedars-sinai.edu.

Brain Mass Lesion

I saw an interesting case of patient with a brain mass lesion this week. The patient came into the hospital presenting with numbness in left arm and lack of coordination. The patient first had a CT, which showed a suspected 1.8 cm mass lesion at right frontal parietal lobe. Then an MRI was ordered, with and without contrast, which confirmed the mass lesion seen on CT. The patient has a history of renal cell carcinoma that was removed 13 months ago. The patients new symptoms confirmed brain metastasis. The patient was then scheduled for MRI Brain lab and taken to surgery the following day. The patient had a right frontoparietal craniotomy with gross total resection of the mass. The patient is scheduled to follow-up with radiation.

The above MRI images are examples of a brain mass lesion. For more information on mass lesion's you can go to: www.residentandstaff.com/.../2007-07_04.asp