MRI Pituitary/Sella

[LisaH]

The MRI that I'll be having day after tomorrow is "MRI PITUITARY/SELLA W&WO CONTRAST" which is to see if the cyst in my head has grown. The person who called me today to confirm my appointment said it will be of my entire brain and will also show my chiari malformation. She wouldn't really tell me anything about the special focus on my pituitary/sella. The neurologist and neurosurgeon said they want to keep an eye on the chiari malformation, too. I'm just not sure how a specially ordered MRI for the pituitary/sella is different from a regular MRI with/without contrast. Does anyone here know if this type of scan will also detect possible plaques/lesions? Thanks in advance for any feedback.

[NHE]

Here's an article which covers the basics of pituitary imaging.

https://radiopaedia.org/articles/pituit ... approach-1

... and search results for pituitary sella.

https://radiopaedia.org/search?utf8=%E2 ... tary+sella

Hopefully, some of the links will be useful for you.

[LisaH]

Thank you for the links. One site that I visited (http://www.doctorslounge.com/neurology/ ... 48681.html) said this: "MRI of the pituitary gland is not to be relied upon to comment about the rest of the brain, which needs a different protocol." so I don't feel confident that the type of MRI I'm having would be useful for possible lesions.

[LisaH]

Well, I had my follow-up MRI and visit with the neurosurgeon. Only my pituitary was actually focused on to check the cyst which apparently hasn't grown. That's the only good news because the neurosurgeon is now saying that he isn't sure if it's a cyst or a tumor. He says the only way to be sure is to remove it. I was extremely discouraged to read on my radiology report: "the entire brain was not completely imaged so that focus could be directed to the sella" and those images are very low quality. The MRI that I had in November was much better. I explained my new symptoms since my visit with the neurosurgeon in January. He doesn't feel that the cyst/tumor/whatever is the causing them and can't explain what is. He even had the nerve to say that tremors (my latest symptom although mild) are often due to aging. I'm 46. He said that my myoclonic jerks cannot be explained because the cause is unknown. I just read about numerous causes on the Mayo Clinic website: http://www.mayoclinic.org/diseases-cond ... c-20166172. I was hoping that the MRI was going to reveal something to explain what I'm going through. I've considered asking my neurologist to order an MRI like I had last year, but I don't know how long I'd have to wait for that to happen. I'm so depressed right now and have been crying off and on for hours.

[LisaH]

At the least, a few words of encouragement would have been nice. I won't waste server space by posting here again.

[NHE]

At the least, a few words of encouragement would have been nice. I won't waste server space by posting here again.

I'm sorry to hear that you feel that way. We are all volunteers here. Regarding your symptoms...

I'm not a neurologist, or a doctor for that matter, but I would be surprised if a cyst the size of yours is not causing some type of symptom. If it were me, I would refuse any diagnosis until the cyst was dealt with or definitively ruled out.

[LisaH]

Thank you for taking the time to post a reply, NHE. The doctors say that the cyst/tumor is an incidental finding and is not responsible for my symptoms. I'm very disappointed in my neurologist and the neurosurgeon because they aren't bothering to look for other causes. It hurts having your symptoms dismissed as common everyday occurrences when it's obviously not true. I woke up this morning with worse head pain and was trembling in my head and arms. It was like being extremely cold but I wasn't cold at all. I was well-rested and wasn't stressed out at all. I called my neurologist's office who discussed it and called me back. I was told to go to the emergency room or to my primary care provider. I explained that my regular doctor referred me to specialists for a reason and that I can't imagine what the ER would do for my symptoms. They seem to be incapable or unwilling to look for an underlying cause.

[NHE]

You may need to find different doctors. Insurance should cover a second opinion.

[ebrownkirkland]

OMG, Lisa. I am SO sorry you're going through all this. Do you live in a small town? I am fortunate in that I live in the DC area and there are TONS of great doctors here. I pretty much have my pick of specialists. If you are nearby another specialist (or even if you're not) I would do as NHE suggests and seek a second opinion. I can't believe they haven't done an MRI of the rest of your brain. That is just crazy!

[LisaH]

Thanks for the replies. I agree that a second opinion would be a good idea. After my first MRI, my doctor referred me to the nearest neurologist (an hour away). They looked at my MRI and refused to even see me for my head pain because of the giant cyst/tumor. I was referred to a neurosurgeon who said, "You need to be in a university setting" and that's where I've ended up. The neurosurgeon referred me to a neurologist who diagnosed me with occipital and trigeminal neuralgia, but the primary focus has continued to be on the cyst. I'm jerking and trembling as I type this and it seems even more pronounced than yesterday. Calling my doctors is pointless since I'll be told to go to the emergency room. What could they do? The hospital here is substandard and they couldn't diagnose whatever is happening to me. I would most likely be told to see my regular doctor. It seems that my symptoms will have to progress to a more documentable stage and then I might be taken seriously.