d*******n
发帖数: 1 | 1 很长一段时间（一年多）一直觉得嘴里发甜。血糖等各项指标一直正常。家庭医生推荐
了耳鼻喉科医生，医生建议做个脑部的MRI.做完后医生看过了报告后说脑部没什么异常
。 不知道有没有必要再找脑神经科的医生看一下？ 报告如下。小时侯得过鼻窦炎，出
国后就没什么症状了。平时有时候会有头疼，主要集中在脑门部位。喝杯咖啡，或者睡
一觉就没事了。
谢谢
Technique Used: .
MRI of the Brain Without & With Contrast: Axial DWI, sagittal T1, Sag 3D
FLAIR, axial SWI, Axial
T2 and FLAIR; Following an injection of 8.5ml Optimark: Coronal T2 and
Sagittal 3D T1 MPRAGE.
Reformat: axial, coronal, and sagittal T1 post contrast.
Symptoms: .
Altered taste described as sweet.
Body: .
MRI of the Brain: There are 7 small (1.5-3.0 mm) focal T2 FLAIR
hyperintensities scattered within the
supratentorial brain involving deep and predominantly subcortical white
matter. None demonstrates
diffusion restriction or contrast enhancement. The brain parenchyma is
otherwise normal in
appearance without hemorrhage, mass/mass effect or midline shift. There is a
normal enhancement
pattern of the brain without signs of inflammation or compromise of the
blood-brain barrier. Diffusion
sequences and ADC map suggest no acute or subacute ischemia. Susceptibility
weighted sequences
demonstrate no signs of previous microhemorrhage or abnormal parenchymal
calcification.
The central through left lateral portion of the clivus is relatively
hyperintense compared to the right
portion on pre-and postcontrast T1, FLAIR and T2 images suggesting this may
be due to
intraosseous hemangioma. The sella, parasellar regions, clivus,
cervicomedullary junction and
cerebellar tonsils are otherwise unremarkable.
Major venous structures including superior sagittal, bilateral transverse,
sigmoid sinuses and jugular
bulbs enhance normally. The orbits and periorbital anatomy are normal. The
internal auditory canals
are grossly unremarkable. There is mild mucosal thickening within the
maxillary sinuses and within
ethmoid air cells. There is an 8 mm retention cyst within a left middle
ethmoid air cell. The paranasal
sinuses and petromastoid air cells are otherwise aerated.
Screening MRA of the Intracranial Vasculature: The bilateral distal cervical
carotid arteries, as well as
intracranial internal carotid arteries, and middle cerebral arteries are
within normal limits. The
anterior circulation is co-dominant with a patent anterior communicating
artery. The posterior
circulation is left-vertebral dominant. No aneurysms, stenoses or vascular
malformations.
Impression: .
1. Seven small focal hyperintensities involving deep but predominantly
subcortical supratentorial
white matter. These are nonspecific and may be within the spectrum of normal
. Minimal
postinflammatory, post ischemic gliotic changes, migraine disease may be
additional considerations.
2. There is a probable intraosseous hemangioma involving the central through
left lateral clivus. This
is likely incidental. No extraosseous extension is appreciated.
3. 8 mm retention cyst within a left middle ethmoid air cell and otherwise
mild mucosal thickening
within the maxillary sinuses and ethmoid air cells.
4. Otherwise unremarkable MRI of the brain without and with contrast.
5. Normal screening MRA of the intracranial vasculature. | l*h
发帖数: 4124 | 2 the cause of altered taste, if not coupled with other symptoms, is very
challenging to diagnose.
a few questions:
1. age? gender?
2. do you take any medicines, nutritional supplements, special food etc.?
3. do you have any known diseases?
4. ask your family doctor to evaluate your nutritional status (whether you
are deficient of certain elements, such as Zinc.)
5. ask a physician or dentist to evaluate your salivation and oral cavity,
including whether there are any gum or dental diseases.
6. ask a neurologist to test whether this is tied to specific locations on
the tongue, so you can tell whether it is tied to the facial nerve or
glossopharyngeal nerve. have your ear canals evaluated. this can be done by
an ENT specialist. some neurologists and neurosurgeons are also comfortable
in doing it themselves.
7. next steps will depend on the results from previous steps.
regarding the MRI report, it is a fairly thorough report, but there is one
component missing, that is, no description of cranial nerves. if the
coverage of the brainstem is good, ask the neuroradiologist to read it again
, pay attention to cranial nerves. if not, wait until you have other test
results before deciding whether you need to have a good scan of the
brainstem. he saw something and suspected hemangioma. the location is not
far away from the path of facial nerve.
【在 d*******n 的大作中提到】
: 很长一段时间（一年多）一直觉得嘴里发甜。血糖等各项指标一直正常。家庭医生推荐
: 了耳鼻喉科医生，医生建议做个脑部的MRI.做完后医生看过了报告后说脑部没什么异常
: 。 不知道有没有必要再找脑神经科的医生看一下？ 报告如下。小时侯得过鼻窦炎，出
: 国后就没什么症状了。平时有时候会有头疼，主要集中在脑门部位。喝杯咖啡，或者睡
: 一觉就没事了。
: 谢谢
: Technique Used: .
: MRI of the Brain Without & With Contrast: Axial DWI, sagittal T1, Sag 3D
: FLAIR, axial SWI, Axial
: T2 and FLAIR; Following an injection of 8.5ml Optimark: Coronal T2 and
| l*h
发帖数: 4124 | 3 “if the coverage of the brainstem is good”
i should clarify this: brainstem is covered in brain routine. i should have
said "if the quality of brainstem images is good,"
【在 l*h 的大作中提到】
: the cause of altered taste, if not coupled with other symptoms, is very
: challenging to diagnose.
: a few questions:
: 1. age? gender?
: 2. do you take any medicines, nutritional supplements, special food etc.?
: 3. do you have any known diseases?
: 4. ask your family doctor to evaluate your nutritional status (whether you
: are deficient of certain elements, such as Zinc.)
: 5. ask a physician or dentist to evaluate your salivation and oral cavity,
: including whether there are any gum or dental diseases.
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