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Stroke

White matter of brain

11/15/2007

Question:

In your opinion, if an MRI is showing a mass that is consuming all of the white matter on the right side of the brain, could it, in your best guess, be a benign brain tumor? It originally caused a few moderately severe symptoms such as dizziness, clumsyness, irritability, and spells that appeared to put her instantly to sleep for a short while. This was discovered in 2000 and lasted a couple years but since that time the symptoms have greatly tapered off. The condition in question has been referred to as a brain lesion, organic brain disease, a brain tumor, and she has been tested for all the other issues noted that could be causes as well. Just curios if you have any comments or suggestions on this matter considering the only for sure option is to do a biopsy on the tissue and she feels that is too risky (her father is deceased from a brain tumor, when a biopsy was performed). Could the possibility exist that it is a tumor even if there are rarely any severe symptoms, as before, and her condition doesn`t appear to be worsening at all. Any information would be appreciated. Thank You.

Answer:

From the information provided, I cannot give you much help. Obviously it is important to be able to look at the imaging and correlate that with the symptoms that the patient is experiencing. It sounds as if you have seen several doctors who are not able to give a certain answer despite multiple imaging studies, and who have recommended brain biopsy. If this is true, it sounds like the most reasonable course. Without an actual diagnosis, all potential efforts to treat the problem are pure speculation.

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Response by:

Brett   Kissela, MD Brett Kissela, MD
Assistant Professor of Neurology
Director, Neurology Residency Program
College of Medicine
University of Cincinnati